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Efficacy and safety of MK-1293 insulin glargine compared with originator insulin glargine (Lantus) in type 1 diabetes: A randomized, open-label clinical trial

Lookup NU author(s): Emeritus Professor Philip Home

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Abstract

© 2018 John Wiley & Sons Ltd Aim: To compare the efficacy and safety of MK-1293 insulin glargine (Mk-Gla; 100 U/mL) with originator insulin glargine, Lantus (Sa-Gla), in people with type 1 diabetes mellitus (T1DM). Materials and methods: This phase 3, randomized, active-controlled, open-label, 52-week study (ClinicalTrials.gov NCT02059161) enrolled 508 people with T1DM (HbA1c ≤11.0%; 97 mmol/mol) taking basal and prandial insulin. Participants were randomized 1:1 to once-daily Mk-Gla (n = 245) or Sa-Gla (n = 263). Dose titration of basal insulin was by a pre-breakfast plasma glucose dosing algorithm. The primary efficacy objective was assessment of the non-inferiority of HbA1c change from baseline (margin of 0.40% [4.4 mmol/mol]) for Mk-Gla compared with Sa-Gla over 24 weeks. The primary safety objective was assessment of anti-insulin antibody development over 24 weeks. Results: The least squares (LS) mean HbA1c change from baseline at week 24 was −0.62 (95% CI −0.79, −0.45)% (−6.8 [−8.7, −4.9] mmol/mol) and −0.66 (−0.82, −0.50)% (−7.2 [−9.0, −5.4] mmol/mol) for Mk-Gla and Sa-Gla. The LS mean HbA1c difference was 0.04 (−0.11, 0.19)% (0.4 [−1.2, 2.0] mmol/mol) for Mk-Gla minus Sa-Gla, meeting the primary and secondary objective criteria for non-inferiority and equivalence. Week 24 mean insulin glargine dose for Mk-Gla and Sa-Gla was 0.46 and 0.48 U/kg, respectively. Similarity of HbA1c response and basal insulin dose trajectory persisted over the 52 weeks. Safety and tolerability, including anti-insulin antibody responses, hypoglycaemia, adverse events and body weight, were similar between insulins over the 52-week study duration. Conclusions: Mk-Gla and Sa-Gla exhibited similar efficacy and safety over 52 weeks in people with T1DM. ClinicalTrials.gov: NCT02059161.

Publication metadata

Author(s): Home PD, Lam RLH, Carofano WL, Golm GT, Eldor R, Crutchlow MF, Marcos MC, Rosenstock J, Hollander PA, Gallwitz B

Publication type: Article

Publication status: Published

Journal: Diabetes, Obesity and Metabolism

Year: 2018

Volume: 20

Issue: 9

Pages: 2220-2228

Print publication date: 01/09/2018

Online publication date: 15/05/2018

Acceptance date: 07/05/2018

ISSN (print): 1462-8902

ISSN (electronic): 1463-1326

Publisher: Wiley-Blackwell

URL: https://doi.org/10.1111/dom.13354

DOI: 10.1111/dom.13354

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