Comparative efficacy and safety of Gla-300 versus IDegAsp in insulin-naive people with type 2 diabetes mellitus uncontrolled on oral anti-diabetics


Ritzel R., Ghosh S., EMRAL R., Malek R., Zeng L., Mabunay M. A., ...Daha Fazla

DIABETES OBESITY & METABOLISM, cilt.25, sa.9, ss.2495-2504, 2023 (SCI-Expanded) identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 25 Sayı: 9
  • Basım Tarihi: 2023
  • Doi Numarası: 10.1111/dom.15121
  • Dergi Adı: DIABETES OBESITY & METABOLISM
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, CAB Abstracts, EMBASE, Food Science & Technology Abstracts, MEDLINE, Veterinary Science Database
  • Sayfa Sayıları: ss.2495-2504
  • Anahtar Kelimeler: efficacy, indirect treatment comparison, insulin degludec-insulin aspart, insulin glargine, meta-analysis, safety, GLARGINE 100 U/ML, GLYCEMIC CONTROL, DRUGS
  • Ankara Üniversitesi Adresli: Evet

Özet

Aim To compare the efficacy and safety of insulin glargine-300 once daily (Gla-300) with insulin degludec/aspart (IDegAsp) once daily in patients with type 2 diabetes (T2D) inadequately controlled on oral anti-diabetic drugs (OADs).Materials and methods A systematic literature review of randomized controlled trials was followed by an indirect treatment comparison of studies involving insulin naive adults, inadequately controlled [glycated haemoglobin (HbA1c) = 7.0%] on OADs, who received Gla-300 or IDegAsp once daily. Outcomes of interest were change in HbA1c, blood glucose, weight and insulin dose, as well as incidence and event rate of hypoglycaemia and other adverse events.Results Four trials with broadly similar baseline patient characteristics were included in the meta-analyses and indirect treatment comparison. At 24-28 weeks, the indirect comparison of Gla-300 to IDegAsp once daily estimated no statistically significant difference for change in HbA1c (%) from baseline [mean difference of 0.10% (95% CI: -0.20, 0.39; p = .52)]; a statistically significant mean difference of -1.31 kg (95% CI: -1.97, -0.65; p < .05) for change in body weight from baseline; statistically significant odds ratios of 0.62 (95% CI: 0.41, 0.93; p < .05) for incidence of any hypoglycaemia; and 0.47 (95% CI: 0.25, 0.87; p < .05) for incidence of anytime confirmed hypoglycaemia (plasma glucose <3.0-3.1 mmol/L). No significant differences were observed for insulin dose and adverse events.Conclusion In insulin-naive patients with T2D inadequately controlled on OADs, commencing Gla-300 shows a comparable HbA1c reduction, but with significantly less weight gain and a lower incidence of any and confirmed hypoglycaemia compared with commencing IDegAsp.