Once-daily prandial lixisenatide versus once-daily rapid-acting insulin in patients with type 2 diabetes mellitus insufficiently controlled with basal insulin: analysis of data from five randomized, controlled trials

被引:28
作者
Raccah, Denis [1 ]
Lin, Jay [2 ]
Wang, Edward [3 ]
Germe, Maeva [4 ]
Perfetti, Riccardo [4 ]
Bonadonna, Riccardo C. [5 ,6 ]
de Pablos-Velasco, Pedro [7 ]
Roussel, Ronan [8 ,9 ,10 ]
Rosenstock, Julio [11 ]
机构
[1] Univ Hosp St Marguerite, Marseille, France
[2] Novosys Hlth, Outcomes Res, Flemington, NJ USA
[3] Sanofi Aventis US, Diabet Metab Franchise, Bridgewater, MA USA
[4] Sanofi, Diabet Metab Franchise, Paris, France
[5] Univ Verona, Sch Med, I-37100 Verona, Italy
[6] Univ Integrata Verona, Azienda Osped, Verona, Italy
[7] Las Palmas Univ, Dr Negrin Hosp, Las Palmas Gran Canaria, Spain
[8] Hop Xavier Bichat, AP HP, Dept Diabetol Endocrinol & Nutr, Paris, France
[9] INSERM, Res Unit 872, Paris, France
[10] Univ Paris Diderot, Sorbonne Paris Cite, UFR Med, Paris, France
[11] Dallas Diabet & Endocrine Ctr Med City, Dallas, TX USA
关键词
Lixisenatide; Basal insulin; Basal plus RAI; GLP-1 receptor agonist; EUROPEAN-ASSOCIATION; GLYCEMIC CONTROL; THERAPY; MANAGEMENT; HYPERGLYCEMIA; GLUCOSE; INTENSIFICATION; INITIATION; STATEMENT; GLARGINE;
D O I
10.1016/j.jdiacomp.2013.10.003
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aims: To compare the efficacy and safety of lixisenatide (LIXI), a once-daily prandial glucagon-like peptide-1 (GLP-1) receptor agonist, as add-on to basal insulin (Basal + LIXI) versus once-daily rapid-acting insulin (Basal + RAI) in patients with type 2 diabetes mellitus (T2DM). Methods: Data were extracted from five randomized controlled trials assessing the efficacy and safety of basal insulin + insulin glulisine (n = 3) or basal insulin + LIXI (n = 2). Patients in the Basal + LIXI cohort were matched to patients in the Basal + RAI cohort using propensity score matching. Results: In the matched population, Basal + LIXI was twice as likely to reach composite outcomes of glycated haemoglobin (HbA(1c)) <7% and no symptomatic hypoglycaemia compared with the Basal + RAI group (odds ratio [OR]: 1.90; 95% confidence interval [CI]: 1.01, 3.55; P = 0.0455), as well as HbA(1c) <7% and no severe hypoglycaemia (OR: 1.97; 95 CI: 1.06, 3.66; P = 0.0311). Furthermore, Basal + LIXI was more than twice as likely to reach HbA(1c) <7%, no weight gain and no symptomatic hypoglycaemia (OR: 2.58; 95% CI: 1.23, 5.40; P = 0.0119). Conclusions: Both basal + LIXI and Basal + RAI improved glycaemic control in patients with T2DM with inadequate glycaemic control on basal insulin. Basal + LIXI offers an effective therapeutic option to advance basal insulin therapy, improving glucose control without weight gain and with less risk of hypoglycaemia than prandial insulin. (C) 2014 Published by Elsevier Inc.
引用
收藏
页码:40 / 44
页数:5
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