Evidence map›Paper›PMID 42680157›Full record

Trial reportDiabetes, obesity & metabolism2026

Insulin Efsitora Demonstrates Similar Efficacy and Safety Profiles to Insulin Icodec in Insulin-Experienced Individuals With Type 2 Diabetes Mellitus: Matching-Adjusted Indirect Comparisons of QWINT-3 Versus ONWARDS 2, and QWINT-4 Versus ONWARDS 4.

Harpreet S Bajaj, Marvin Fischer, Michael B Davidson, Abdul M Tarafder, Christopher J Michaels, Rachel H Tao, Alex Pashley, Jess Amis, Josefine Redig

Abstract readRandomized Controlled TrialComparative StudyMulticenter Study
In one paragraph

Trial report in Diabetes, obesity & metabolism, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Harpreet S BajajEndocrine and Metabolic Research, LMC Diabetes and Endocrinology, Brampton, Ontario, Canada.ORCID https://orcid.org/0000-0002-1461-1465
Marvin FischerEli Lilly and Company, Indianapolis, USA.
Michael B DavidsonEli Lilly and Company, Indianapolis, USA.ORCID https://orcid.org/0009-0001-1235-6990
Abdul M TarafderEli Lilly and Company, Indianapolis, USA.
Christopher J MichaelsCostello Medical, London, UK.
Rachel H TaoCostello Medical, London, UK.
Alex PashleyCostello Medical, Cambridge, UK.
Jess AmisCostello Medical, Manchester, UK.
Josefine RedigEli Lilly and Company, Indianapolis, USA.

Funding

Eli Lilly and Company
6 · The paper itself

Abstract

aimsTo conduct indirect treatment comparisons (ITCs) of insulin efsitora alfa (efsitora) versus insulin icodec (icodec) in insulin-experienced individuals with Type 2 Diabetes Mellitus.

methodsEfficacy, safety and patient reported outcomes were compared via matching-adjusted ITCs using results from randomised controlled trials: QWINT-3 versus ONWARDS 2 (basal-insulin experienced individuals) and QWINT-4 versus ONWARDS 4 (basal-bolus insulin-experienced individuals).

resultsIn basal insulin-experienced participants, efsitora was comparable to icodec for change from baseline (CfB) in HbA1c (%) (efficacy estimand mean difference [MD] [95% CI]: 0.137 [-0.058, 0.333]), proportion of participants (PoP) discontinuing treatment due to adverse event (risk difference: -0.0002 [-0.0223, 0.0220]) and CfB in Diabetes Treatment Satisfaction Questionnaire-Change (DTSQc) (MD: 1.01 [-0.243, 2.27]). Efsitora exhibited significantly reduced weight gain (MD: -1.52 kg [-2.60, -0.447]) and had lower event rates of Level 2 or 3 hypoglycaemia (rate ratio: 0.436 [0.241, 0.786]) versus icodec, despite no significant difference in PoP with Level 2 or 3 hypoglycaemia (odds ratio [OR]: 0.581 [0.294, 1.14]). In basal-bolus insulin-experienced participants, efsitora was comparable to icodec: CfB in HbA1c (%) (MD: -0.0447 [-0.252, 0.163]); CfB in body weight (kg) (MD: -0.316 [-1.45, 0.817]); PoP with Level 2 or 3 hypoglycaemia (OR: 1.10 [0.698, 1.73]); event rate of Level 2 or 3 hypoglycaemia (rate ratio [95% CI]: 1.03 [0.759, 1.39]).

conclusionsThese indirect comparisons suggest that efsitora had lower event rates of hypoglycaemia and less weight gain compared to icodec in basal insulin-experienced participants. Efsitora was comparable to icodec for all other endpoints.

Indexed as

Diabetes Mellitus, Type 2Hypoglycemic AgentsInsulinAgedBlood GlucoseFemaleGlycated HemoglobinHumansHypoglycemiaInsulinsMaleMiddle AgedRecombinant Fusion ProteinsTreatment OutcomeBlood GlucoseEfsitoraGlycated Hemoglobinhemoglobin A1c protein, humanHypoglycemic AgentsInsulinInsulinsRecombinant Fusion Proteinsbasal insulinglycaemic controlhypoglycaemiatype 2 diabetesweight control

Identifiers

PMID42680157
PMCPMC13646356

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.