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LY2963016 胰岛素甘精和胰岛素甘精(来得时®)在初治或既往使用胰岛素甘精的 2 型糖尿病患者中的疗效和安全性相似:一项随机、双盲对照试验(ELEMENT 2 研究)。

Similar efficacy and safety of LY2963016 insulin glargine and insulin glargine (Lantus®) in patients with type 2 diabetes who were insulin-naïve or previously treated with insulin glargine: a randomized, double-blind controlled trial (the ELEMENT 2 study).

机构信息

Dallas Diabetes and Endocrine Center at Medical City, Dallas, TX, USA.

Baylor Endocrine Center, Dallas, TX, USA.

出版信息

Diabetes Obes Metab. 2015 Aug;17(8):734-41. doi: 10.1111/dom.12482. Epub 2015 May 31.

Abstract

AIMS

To compare the efficacy and safety of LY2963016 insulin glargine (LY IGlar) and the reference product (Lantus(®)) insulin glargine (IGlar) in combination with oral antihyperglycaemic medications in patients with type 2 diabetes (T2D).

METHODS

This phase III, randomized, double-blind, 24-week study enrolled patients with T2D who were insulin-naïve [glycated haemoglobin (HbA1c) ≥7 and ≤11.0%] or previously on IGlar (HbA1c ≤11%) and treated with ≥2 oral antihyperglycaemic medications. Patients were randomized to receive once-daily LY IGlar (n = 376) or IGlar (n = 380) for 24 weeks. The primary efficacy outcome was to test the non-inferiority (0.4% and then 0.3% margin) of LY IGlar to IGlar, as measured by change in HbA1c from baseline to 24 weeks.

RESULTS

Both treatment groups had similar and significant (p < 0.001) within-group decreases in mean HbA1c values from baseline. LY IGlar met non-inferiority criteria compared with IGlar for change in HbA1c from baseline [-1.29 vs -1.34%; respectively, least-squares mean difference 0.052% (95% confidence interval -0.070 to 0.175); p > 0.05]. There were no treatment differences (p > 0.05) in fasting plasma glucose, proportion of patients reaching HbA1c <7% or insulin dose at 24 weeks. Adverse events, allergic reactions, weight change, hypoglycaemia and insulin antibodies were similar between treatment groups. Similar findings were observed in patients who were insulin-naïve or previously treated with IGlar at baseline.

CONCLUSIONS

Both LY IGlar and IGlar, when used in combination with oral antihyperglycaemic medications, provided effective and similar glucose control with similar safety profiles in patients with T2D.

摘要

目的

比较LY2963016 甘精胰岛素(LY IGlar)与参考产品(来得时(®))甘精胰岛素(IGlar)联合口服降糖药物治疗 2 型糖尿病(T2D)患者的疗效和安全性。

方法

这是一项为期 24 周、随机、双盲、III 期研究,纳入了胰岛素初治(糖化血红蛋白(HbA1c)≥7 且≤11.0%)或之前使用 IGlar(HbA1c≤11%)且接受≥2 种口服降糖药物治疗的 T2D 患者。患者被随机分为每日一次接受 LY IGlar(n=376)或 IGlar(n=380)治疗 24 周。主要疗效终点是比较 LY IGlar 与 IGlar 的非劣效性(0.4%,然后是 0.3%的边界),以 24 周时 HbA1c 从基线的变化来衡量。

结果

两组治疗均使 HbA1c 均值从基线显著(p<0.001)和相似的降低。LY IGlar 与 IGlar 相比,HbA1c 从基线的变化达到非劣效性标准[-1.29 与-1.34%;分别为最小二乘均数差值 0.052%(95%置信区间-0.070 至 0.175);p>0.05]。两组患者在空腹血糖、24 周时达到 HbA1c<7%的患者比例或胰岛素剂量方面无治疗差异(p>0.05)。两组治疗组之间不良反应、过敏反应、体重变化、低血糖和胰岛素抗体发生率相似。在基线时胰岛素初治或之前使用 IGlar 的患者中观察到了相似的结果。

结论

在与口服降糖药物联合使用时,LY IGlar 和 IGlar 均能有效控制血糖,安全性相似,在 T2D 患者中具有相似的疗效。

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