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Rosenstock, Julio; Cheng, Alice; Ritzel, Robert; Bosnyak, Zsolt; Devisme, Christine; Cali, Anna M G; Sieber, Jochen; Stella, Peter; Wang, Xiangling; Frías, Juan P; Roussel, Ronan; Bolli, Geremia B
Diabetes care, 10/2018, Letnik: 41, Številka: 10Journal Article
To compare insulin glargine 300 units/mL (Gla-300) versus insulin degludec 100 units/mL (IDeg-100) in this first head-to-head randomized controlled trial. BRIGHT (NCT02738151) was a multicenter, open-label, active-controlled, two-arm, parallel-group, 24-week, noninferiority study in insulin-naive patients with uncontrolled type 2 diabetes. Participants were randomized 1:1 to evening dosing with Gla-300 ( = 466) or IDeg-100 ( = 463), titrated to fasting self-monitored plasma glucose of 80-100 mg/dL. The primary end point was HbA change from baseline to week 24. Safety end points included incidence and event rates of hypoglycemia. At week 24, HbA improved similarly from baseline values of 8.7% (72 mmol/mol) in the Gla-300 group and 8.6% (70 mmol/mol) in the IDeg-100 group to 7.0% (53 mmol/mol)-least squares mean difference -0.05% (95% CI -0.15 to 0.05) (-0.6 mmol/mol -1.7 to 0.6)-demonstrating noninferiority of Gla-300 versus IDeg-100 ( < 0.0001). Hypoglycemia incidence and event rates over 24 weeks were comparable with both insulins, whereas during the active titration period (0-12 weeks) the incidence and rate of anytime (24-h) confirmed hypoglycemia (≤70 and <54 mg/dL) were lower with Gla-300. Both insulins were properly titrated and exhibited no specific safety concerns. Gla-300 and IDeg-100 provided similar glycemic control improvements with relatively low hypoglycemia risk. Hypoglycemia incidence and rates were comparable with both insulins during the full study period but lower in favor of Gla-300 during the titration period. The choice between these longer-acting basal insulins may be determined by factors such as access and cost, alongside clinical considerations.
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JCR | SNIP | JCR | SNIP | JCR | SNIP | JCR | SNIP |
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in: SICRIS
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