Abstract

Objective: To compare the change in immunogenic response, safety and efficacy of insulin glargine in Glaritus® and Lantus® treatment arms from baseline to six months in patients with type 2 diabetes mellitus (T2DM) uncontrolled on oral antidiabetic drugs (OADs). Material and methods: In an ongoing prospective, open-label, randomized, parallel-group, comparative, multicenter, phase IV study, adult patients with uncontrolled T2DM are treated with either Glaritus® once daily or Lantus® once daily for six months, both given subcutaneously. Glaritus® treatment arm is to be continued for another six months. The primary endpoint for the study was the percentage change in anti-insulin antibodies (AIA) titer to glargine in both treatment arms from baseline to six months. Results: Ninety patients were randomized to each group. Baseline characteristics were comparable between the groups (p>0.05). There was no significant difference in percent change in the AIA titer between the two treatment arms at the end of six months in ITT (intent-to-treat) and mITT(modified intent to treat) population (LS mean diff [95% CI]: 2.2% (-15.1%, 19.6%), p=0.7987 and 3.4% (-15.1%, 21.9%), p=0.7181, respectively). No significant between-group difference was seen in change in the HbA1c level at the end of six months in ITT and mITT population [LS mean diff (95% CI): -0.2 (-0.4, 0.0), p=0.1072 for ITT population; and -0.1 (-0.3, 0.1), p=0.2283, for mITT population]. There was also no significant difference between two groups for the incidence of adverse events [Glaritus® 17 (18.9%) and Lantus® 20 (22.2%) p=0.5800]. Conclusion: Glaritus® was found to be non-inferior to Lantus® in glycaemic control and comparable in immunogenic response and safety at the end of six months in patients with T2DM uncontrolled on OADs.

Highlights

  • Diabetes mellitus is a metabolic disorder characterized by chronic hyperglycemia with metabolic disturbances occurring due to defects in insulin secretion and/or action

  • The secondary endpoints were the change in HbA1c (%) from baseline to six months, safety assessment at six months in both treatment arms and change in anti-insulin antibodies (AIA) titer to glargine in Glaritus® treatment arm from baseline to 12 months

  • In the modified ITT (mITT) population, the median (IQR) decrease in AIA titer was greater in Lantus® [-14.12 (45.9)%] as compared to the Glaritus® group [-7.13 (44.9)%]

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Summary

Introduction

Diabetes mellitus is a metabolic disorder characterized by chronic hyperglycemia with metabolic disturbances occurring due to defects in insulin secretion and/or action. Poor glycemic control may result in chronic complications, dysfunction or failure of different body organs. A recently published four year retrospective study showed prevalence of macrovascular and microvascular complications in. 31.8% and 35.3% type 2 diabetes mellitus (T2DM) patients respectively. The prevalence of neuropathy, nephropathy and retinopathy, was 20.8%, 12.5% and 6.5% espectively [1]. An optimal glucose regulation in patients with diabetes mellitus reduces the risk of complications. The UK Prospective Diabetes Study (UKPDS), a landmark clinical trial showed that improvement in glycemic control reduced diabetes related complications. The study demonstrated that intensive glucose control can significantly reduce microvascular complications [2]

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