Institute for Clinical and Experimental Medicine and Charles University, Prague, Czech Republic.
Royal North Shore Hospital, University of Sydney, Sydney, Australia.
Diabetes Obes Metab. 2018 Jul;20(7):1585-1592. doi: 10.1111/dom.13261. Epub 2018 Mar 25.
To investigate whether the proven benefits of insulin degludec (IDeg) combined with insulin aspart (IAsp), known as IDegAsp, given twice daily, extend across a wide spectrum of patients with diabetes.
This was a post hoc pooled analysis of 5 phase III randomized, 26-week, open-label, treat-to-target trials comparing IDegAsp twice daily (n = 1111) with one of two comparators: premixed insulin (biphasic insulin aspart 30 [BIAsp 30]) twice daily (n = 561) or IDeg once daily + IAsp (n = 136). Patient data were stratified according to baseline glycated haemoglobin (HbA1c) or fasting plasma glucose (FPG) categories, as well as by baseline duration of diabetes or body mass index (BMI) categories.
We conducted a meta-analysis of 5 clinical trials: NCT01513590, NCT01009580, NCT01059812, NCT01680341 and NCT01713530. End-of-trial results were broadly consistent, with differences between IDegAsp and comparators observed in phase III trials. HbA1c results were similar for IDegAsp and the comparators in all baseline characteristic (HbA1c, duration of diabetes or BMI) and category groups (number ranges). Significantly lower FPG level was observed with IDegAsp vs comparators in all baseline characteristic and most category groups (excluding FPG <5.5 mmol/L). Significantly lower insulin doses were observed with IDegAsp vs comparators in all baseline characteristic and half of the category groups, and significantly lower rates of confirmed and nocturnal confirmed hypoglycaemia were observed with IDegAsp vs comparators in all baseline variable and category groups.
IDegAsp retains a consistent safety and efficacy profile in patients with different baseline characteristics.
研究每日两次给予已证实具有获益的德谷胰岛素(IDeg)联合门冬胰岛素(IAsp)(即 IDegAsp)是否可扩展至涵盖广泛的糖尿病患者人群。
这是一项事后汇总分析,纳入了 5 项为期 26 周、开放标签、以目标为导向的 III 期随机对照试验,比较了每日两次给予 IDegAsp(n=1111)与两种对照药物之一的疗效:每日两次预混胰岛素(双时相门冬胰岛素 30 [BIAsp 30])(n=561)或每日一次德谷胰岛素+门冬胰岛素(n=136)。根据基线糖化血红蛋白(HbA1c)或空腹血糖(FPG)类别以及基线糖尿病持续时间或体重指数(BMI)类别对患者数据进行分层。
我们对 5 项临床试验进行了荟萃分析:NCT01513590、NCT01009580、NCT01059812、NCT01680341 和 NCT01713530。试验末期的结果基本一致,IDegAsp 与对照药物在 III 期试验中观察到了差异。在所有基线特征(HbA1c、糖尿病持续时间或 BMI)和类别组(数值范围)中,IDegAsp 与对照药物的 HbA1c 结果相似。与对照药物相比,IDegAsp 组观察到 FPG 水平显著更低,且在所有基线特征和大多数类别组(除外 FPG<5.5 mmol/L)中均如此。在所有基线特征和一半的类别组中,IDegAsp 组观察到胰岛素剂量显著更低,与对照药物相比,IDegAsp 组还观察到夜间确证和夜间未确证低血糖的发生率显著更低,在所有基线变量和类别组中均如此。
IDegAsp 在具有不同基线特征的患者中保持一致的安全性和疗效特征。