A New Once-Weekly Insulin — Its Effectiveness and Safety

This editorial evaluates the QWINT-2 trial results, which demonstrate the noninferiority of once-weekly insulin efsitora alfa compared to once daily insulin degludec in adults with type 2 diabetes. Efsitora, a novel basal insulin linked to an Fc antibody fragment, showed comparable efficacy in reducing glycated hemoglobin levels (−1.26 vs. −1.17 percentage points) and similar hypoglycemia rates (0.58 vs. 0.45 events per participant year). The trial highlights efsitora’s potential to reduce injection burden while maintaining safety, though its use in type 1 diabetes requires caution due to hypoglycemia risks (as seen with insulin icodec). The editorial underscores efsitora’s promise for patients with disabilities or caregiver limitations, advocating for further research to optimize protocols for diverse populations.

This editorial evaluates the QWINT-2 trial results, which demonstrate the noninferiority of once-weekly insulin efsitora alfa compared to once daily insulin degludec in adults with type 2 diabetes. Efsitora, a novel basal insulin linked to an Fc antibody fragment, showed comparable efficacy in reducing glycated hemoglobin levels (−1.26 vs. −1.17 percentage points) and similar hypoglycemia rates (0.58 vs. 0.45 events per participant year). The trial highlights efsitora’s potential to reduce injection burden while maintaining safety, though its use in type 1 diabetes requires caution due to hypoglycemia risks (as seen with insulin icodec). The editorial underscores efsitora’s promise for patients with disabilities or caregiver limitations, advocating for further research to optimize protocols for diverse populations.