Department of Medicine, University of Toronto, ON, Canada; Trilium Health Partners & Unity Health, Toronto, Canada.
Department of Endocrinology & Nutrition, Hospital de la Santa Creu i Sant Pau CIBERDEM, Barcelona, Spain.
Diabetes Res Clin Pract. 2024 Nov;217:111871. doi: 10.1016/j.diabres.2024.111871. Epub 2024 Sep 27.
To evaluate treatment advancement with insulin glargine 300 U/mL (Gla-300), with or without prior glucagon-like peptide-1 receptor agonist (GLP-1 RA) therapy in type 2 diabetes (T2D).
Efficacy and safety outcomes of insulin-naïve patients intensifying with Gla-300, with/without prior GLP-1 RA therapy, were evaluated in three analyses (N = 3562): a pooled analysis of seven interventional studies, a subanalysis comparing participants who stopped GLP-1 RA therapy and initiated Gla-300 with those who received add-on Gla-300, and an expanded analysis including two observational studies.
Glycaemic outcomes, including HbA1c improvement and fasting plasma glucose, were similar between groups with/without prior GLP-1 RA use. HbA1c least squares mean change from baseline was - 1.7 % and - 1.6 % with and without prior GLP-1 RA, respectively. Glycaemic outcomes were similar between participants who stopped GLP-1 RA therapy when initiating Gla-300 and those who received add-on Gla-300, although more participants receiving add-on Gla-300 achieved HbA1c targets. The expanded analysis yielded similar results. Incidence of hypoglycaemia was low with no clinically relevant weight changes in all analyses.
Treatment advancement with Gla-300 in patients with T2D, with/without prior GLP-1 RA therapy, improved glycaemic outcomes with no relevant impact on weight, while maintaining a low hypoglycaemia risk.
评估甘精胰岛素 300U/mL(Gla-300)联合或不联合胰高血糖素样肽-1 受体激动剂(GLP-1RA)治疗 2 型糖尿病(T2D)患者的治疗进展。
通过 3 项分析(N=3562)评估起始胰岛素治疗的患者(胰岛素初治患者)中,Gla-300 联合/不联合 GLP-1RA 治疗的疗效和安全性结局:7 项干预研究的汇总分析、比较停止 GLP-1RA 治疗并起始 Gla-300 治疗与接受 Gla-300 附加治疗的参与者的亚组分析、包括 2 项观察性研究的扩展分析。
包括 HbA1c 改善和空腹血糖在内的血糖结局在有/无 GLP-1RA 治疗史的组间相似。从基线的 HbA1c 最小二乘均值变化分别为-1.7%和-1.6%,有/无 GLP-1RA 治疗史。起始 Gla-300 治疗时停止 GLP-1RA 治疗的参与者与接受 Gla-300 附加治疗的参与者之间的血糖结局相似,尽管更多接受 Gla-300 附加治疗的参与者达到了 HbA1c 目标。扩展分析也得出了相似的结果。所有分析中低血糖的发生率均较低,且无明显体重变化。
在有/无 GLP-1RA 治疗史的 T2D 患者中,Gla-300 治疗进展改善了血糖结局,对体重无明显影响,同时保持低血糖风险低。