Real-World Use of Insulin Glargine U100 and U300 in Insulin-Naïve Patients with Type 2 Diabetes Mellitus : DosInGlar Study
Duque, Natalia (Departamento Médico, Lilly Alcobendas)
Artime, Esther (Departamento Médico, Lilly Alcobendas)
Romera, Irene (Departamento Médico, Lilly Alcobendas)
Lebrec, Jeremie (HaaPACS GmbH, Schriesheim, Germany)
Díaz-Cerezo, Silvia (Departamento Médico, Lilly Alcobendas)
Rubio, Miriam (Departamento Médico, Lilly Alcobendas)
Sicras Mainar, Antoni (Atrys Health SA, Health Economics and Outcomes Research)
Carretero Anibarro, Enrique (Medicina Familiar y Comunitaria, Unidad de Gestión Clínica Estepa)
Mundet-Tudurí, Xavier (Universitat Autònoma de Barcelona)
Gorgojo Martínez, Juan José (Hospital Universitario Fundación Alcorcón)
Reviriego, Jesús (Departamento Médico, Lilly Alcobendas)

Fecha:	2021
Resumen:	In the EDITION clinical trial programme, patients with type 2 diabetes mellitus (T2DM) receiving insulin glargine (IGlar) U300 required 10-15% more insulin than those receiving IGlar U100. This study sought to determine whether this difference was apparent in real-world practice. In this observational, retrospective cohort study, electronic medical records in the Big-Pac® database (Real Life Data) relating to adult insulin-naïve patients with T2DM who initiated IGlar U100 or U300 treatment in Spain in 2016-2017 and remained on treatment for 18 months were selected. IGlar U100- and U300-treated patients were matched 1:1 (propensity score matching). The primary analysis compared changes from baseline in mean daily IGlar dose (U and U/kg) at 6 (± 2), 12 (± 2) and 18 (± 2) months between cohorts (paired t tests). Changes in glycated haemoglobin (HbA1c) and weight were analysed descriptively. The IGlar U100 and U300 cohorts included 556 matched pairs (46. 9% female) with the following mean (standard deviation) values at baseline, respectively: age 63. 6 (12. 8) versus 63. 7 (11. 9) years; years since diagnosis 9. 5 (1. 4) versus 9. 5 (1. 3); HbA1c 8. 8 (1. 3) versus 8. 7 (1. 5) %; weight 84. 6 (16. 9) versus 84. 7 (17. 1) kg. Mean IGlar dose at baseline was 0. 19 U/kg/day (both cohorts). Patients receiving IGlar U300 showed a greater increase from baseline in IGlar dose at 6, 12 and 18 months [mean dose (U/kg/day) 5. 1%, 10. 3% and 12. 8% greater, respectively, in IGlar U300-treated patients]. Mean HbA1c was 8. 1% in both cohorts at 18 months. Mean (SD) weight at 18 months with IGlar U100 and IGlar300 was 86. 8 (17. 0) kg and 85. 0 (17. 1) kg, respectively. In real-world practice, insulin dose was significantly higher in IGlar U300-treated than U100-treated patients at 6, 12 and 18 months, with similar reductions in HbA1c. At equal IGlar price/unit in Spain, the increased dose requirements of IGlar U300 would result in higher costs. The online version contains supplementary material.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Cost ; Dose ; Glycaemic control ; Insulin glargine ; Real-world evidence ; Type 2 diabetes mellitus ; U100 ; U300
Publicado en:	Advances in Therapy, Vol. 38 (may 2021) , p. 3857-3871, ISSN 1865-8652

DOI: 10.1007/s12325-021-01773-z
PMID: 34052987

15 p, 785.4 KB

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