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Superior efficacy-dose ratio for Lantus

A 76 per cent higher dose of insulin detemir is needed to achieve similar, well-tolerated glycaemic control when compared to Lantus

A study has shown that a 76 per cent higher dose of insulin detemir is needed to achieve similar, well-tolerated glycaemic control when compared to Lantus.

Sanofi-aventis (S-A) announced the results during the 45th annual meeting of the European Association for the Study of Diabetes in Vienna.

In the head-to-head, randomised, non-inferiority controlled clinical trial of 964 patients, those taking Lantus required an average daily dose of 43.5 units to achieve the primary endpoint of HbA1c below 7 per cent without symptomatic hypoglycaemia, compared to patients on insulin detemir, who received 76.5 units – an increase of 76 per cent. Despite lower doses of insulin in the glargine group, Lantus once-daily and insulin detemir twice-daily resulted in similar improvements in glycaemic control and a similar risk of hypoglycaemia. Patients in the Lantus arm of the study also achieved significantly lower fasting blood glucose (-63.1 mg/dL Lantus vs -57.7 mg/dL).

"This study demonstrated that for insulin-naïve patients with type 2 diabetes, initiating insulin therapy with once-daily glargine achieved the same glycaemic control as twice-daily detemir, with somewhat more weight gain, but lower insulin doses," stated study investigator, Hertzel Gerstein, professor of diabetes medicine, faculty of health sciences, Hamilton, Canada.

Patients taking Lantus once-daily reported a significantly greater treatment satisfaction over insulin detemir twice-daily, with over 50 per cent less drop-outs (4.6 per cent vs 10.1 per cent). Discontinuations in patients taking insulin detemir were primarily due to adverse events, including skin reactions.

The insulin-naïve patients were aged between 40 and 75 and had had type 2 diabetes for at least one year with sub-optimal blood glucose control using glucose-lowering drugs.

There was limited weight gain in both groups, with patients on insulin detemir experiencing less weight gain (0.6 versus 1.4kg).

30th September 2009

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