Glargin (Lantus) Initiation after Metformin Achieved Superior Glycemic Control versus Sitagliptin in Type 2 Diabetes. EASIE. The Lancet
Approximately 50 percent more patients on Lantus® achieved target HbA1c
versus sitagliptin at study endpoint –
– EASIE study findings published in The Lancet –
Announced today that people with early type 2 diabetes uncontrolled on metformin demonstrated superior HbA1c - glycated hemoglobin - reduction with Lantus® (insulin glargine [rDNA origin] injection) versus sitagliptin. These data from the EASIE (Evaluation of Insulin Glargine Versus Sitagliptin in Insulin-Naïve Patients) study were presented at the American diabetes Association 72nd Scientific Sessions. Results of the study were also published today online in The Lancet.
“The findings of this study comparing insulin glargine with sitagliptin provide evidence to support the recent ADA-EASD proposal to consider early basal insulin therapy as add-on to metformin to help achieve glycemic control in people with type 2 diabetes,” said principal investigator Pablo Aschner, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Colombia.
In insulin-naïve people with type 2 diabetes, who were inadequately controlled by metformin once-daily, insulin glargine produced superior HbA1c reduction (-1.7%) versus once daily sitagliptin (-1.1%; p<0.001). Notably 50% more patients on insulin glargine achieved HbA1c<7% (68 vs. 42%) and <6.5% (40 vs. 17%) compared to sitagliptin (p<0.0001 for both), indicating improved glycemic control for a greater number of insulin glargine patients. Additionally, a statistically significant improvement in fasting plasma glucose (FPG), a key contributor to glycemic control, was observed for patients on insulin glargine compared to sitagliptin. The mean difference in self-monitored FPG was -41.4 mg/dL (95% CI: -46.8 to -36.0 mg/dL) lower with insulin glargine than with sitagliptin (p<0.0001).
Treatment-emergent adverse events were less frequent in patients on insulin glargine (108 patients [46%]) versus sitagliptin (143 patients [54%]).
Hypoglycemia rates were higher with insulin glargine (4.21 events per patient year versus 0.50 for sitagliptin; p<0.0001). The number of patients with overall symptomatic hypoglycemia and nocturnal symptomatic hypoglycemia, with plasma glucose (PG) < 56 mg/dL, was 56 with insulin glargine compared to 12 with sitagliptin, and 20 vs. 2, respectively. Severe symptomatic hypoglycemia was reported in 3 patients receiving insulin glargine compared to 1 receiving sitagliptin. Severe nocturnal symptomatic hypoglycemia was reported in 1 patient in each group. Mean body weight slightly increased with glargine (+0.4 kg) and decreased with sitagliptin (-1.1 kg).
“The EASIE study adds valuable data to further strengthen the efficacy profile of Lantus® when initiated early in the treatment pathway after metformin,” said Pierre Chancel, Senior Vice President, Global diabetes, Sanofi.
“EASIE is a demonstration of the continued commitment of Sanofi to helping people with type 2 diabetes reach their glycemic targets.”
The study findings are highlighted at the American diabetes Association Scientific Sessions in the following abstract: Evaluation of Insulin Glargine Versus Sitagliptin in Insulin-Naïve Patients (EASIE) With Type 2 diabetes Mellitus (T2DM) Uncontrolled in Metformin (Aschner et al.) [CT-SY22].
EASIE was a multicenter, international, randomized, open-label, six-month study that compared once-daily insulin glargine with sitagliptin (100 mg) once daily, as add-on therapy to metformin, in insulin-naïve people with early type 2 diabetes (median disease duration after diagnosis: 4.5 years).
The primary endpoint was to demonstrate superiority of insulin glargine (n = 227 at study end) over sitagliptin (n = 253 at study end) in change in HbA1c from baseline to study end. Baseline characteristics were similar for both groups.
About Sanofi diabetes
Sanofi strives to help people manage the complex challenge of diabetes by delivering innovative, integrated and personalized solutions. Driven by valuable insights that come from listening to and engaging with people living with diabetes, the Company is forming partnerships to offer diagnostics, therapies, services and devices, including innovative blood glucose monitoring systems. Sanofi markets both injectable and oral medications for people with type 1 or type 2 diabetes. Investigational compounds in the pipeline include an injectable GLP-1 agonist being studied as a single agent, in combination with basal insulin, and/or in combination with oral antidiabetic agents.
1. World Health Organisation diabetes fact sheet, August 2011
2. UK Prospective diabetes Study (UKPDS) Group, Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33), Lancet 1998;352(9131):837-853
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