Clements Jennifer N, Bello Larkin
Department of Pharmacy Practice, Presbyterian College School of Pharmacy, Clinton, SC.
Presbyterian College School of Pharmacy, Clinton, SC.
Am J Health Syst Pharm. 2016 Mar 15;73(6):359-66. doi: 10.2146/ajhp150174.
The pharmacokinetics, efficacy, and safety of U-300 insulin glargine for the management of diabetes are reviewed.
U-300 (300 units/mL) insulin glargine is a long-acting basal insulin with low within-day variability, high day-to-day reproducibility, longer duration, and constant pharmacokinetic profile compared with U-100 (100 units/mL) insulin glargine. U-300 was evaluated in six randomized, active-comparator, open-label, Phase III clinical studies (EDITION trials) among patients with type 1 or 2 diabetes. The primary endpoint for all EDITION studies was the reduction in glycosylated hemoglobin from baseline to six months. Safety endpoints included confirmed or nocturnal hypoglycemia between week 9 and month 6 and the change in weight from baseline. For hypoglycemic episodes, U-300 insulin glargine was superior to U-100 insulin glargine when comparing the risk of hypoglycemia. U-300 insulin glargine is supplied in a prefilled device (for safety purposes) and packaged in boxes of three or five pens. It is still early to determine the role of U-300 insulin glargine in diabetes management. When compared with U-100 insulin glargine, U-300 insulin glargine appeared to be associated with a lower risk of hypoglycemia and nocturnal hypoglycemia, most likely due to its pharmacokinetics. The wholesale average cost of U-300 insulin glargine is $335.48 per box of three pens.
The efficacy outcomes of U-300 insulin glargine were similar to those of U-100 insulin glargine, but the constant pharmacokinetic profile and longer duration of action of U-300 insulin glargine may help certain patients with type 1 or type 2 diabetes achieve better glycemic control.
综述U-300甘精胰岛素治疗糖尿病的药代动力学、疗效及安全性。
与U-100(100单位/毫升)甘精胰岛素相比,U-300(300单位/毫升)甘精胰岛素是一种长效基础胰岛素,日内变异性低、日间重复性高、作用持续时间长且药代动力学特征稳定。在1型或2型糖尿病患者中进行了六项随机、活性对照、开放标签的III期临床研究(EDITION试验)对U-300进行评估。所有EDITION研究的主要终点是糖化血红蛋白从基线至6个月的降幅。安全性终点包括第9周和第6个月之间确诊的或夜间低血糖以及体重相对于基线的变化。对于低血糖事件,比较低血糖风险时,U-300甘精胰岛素优于U-100甘精胰岛素。U-300甘精胰岛素采用预填充装置(出于安全目的)供应,每盒包装三支或五支笔。确定U-300甘精胰岛素在糖尿病管理中的作用仍为时过早。与U-100甘精胰岛素相比,U-300甘精胰岛素似乎与较低的低血糖和夜间低血糖风险相关,这很可能归因于其药代动力学。U-300甘精胰岛素的批发平均成本为每盒三支笔335.48美元。
U-300甘精胰岛素的疗效结果与U-100甘精胰岛素相似,但U-300甘精胰岛素稳定的药代动力学特征和更长的作用持续时间可能有助于某些1型或2型糖尿病患者实现更好的血糖控制。