PMID- 26880669
OWN - NLM
STAT- MEDLINE
DCOM- 20161031
LR  - 20240327
IS  - 2044-6055 (Electronic)
IS  - 2044-6055 (Linking)
VI  - 6
IP  - 2
DP  - 2016 Feb 15
TI  - Safety and efficacy of insulin glargine 300 u/mL compared with other basal 
      insulin therapies in patients with type 2 diabetes mellitus: a network 
      meta-analysis.
PG  - e009421
LID - 10.1136/bmjopen-2015-009421 [doi]
LID - e009421
AB  - OBJECTIVE: To compare the efficacy and safety of a concentrated formulation of 
      insulin glargine (Gla-300) with other basal insulin therapies in patients with 
      type 2 diabetes mellitus (T2DM). DESIGN: This was a network meta-analysis (NMA) 
      of randomised clinical trials of basal insulin therapy in T2DM identified via a 
      systematic literature review of Cochrane library databases, MEDLINE and MEDLINE 
      In-Process, EMBASE and PsycINFO. OUTCOME MEASURES: Changes in HbA1c (%) and body 
      weight, and rates of nocturnal and documented symptomatic hypoglycaemia were 
      assessed. RESULTS: 41 studies were included; 25 studies comprised the main 
      analysis population: patients on basal insulin-supported oral therapy (BOT). 
      Change in glycated haemoglobin (HbA1c) was comparable between Gla-300 and detemir 
      (difference: -0.08; 95% credible interval (CrI): -0.40 to 0.24), neutral 
      protamine Hagedorn (NPH; 0.01; -0.28 to 0.32), degludec (-0.12; -0.42 to 0.20) 
      and premixed insulin (0.26; -0.04 to 0.58). Change in body weight was comparable 
      between Gla-300 and detemir (0.69; -0.31 to 1.71), NPH (-0.76; -1.75 to 0.21) and 
      degludec (-0.63; -1.63 to 0.35), but significantly lower compared with premixed 
      insulin (-1.83; -2.85 to -0.75). Gla-300 was associated with a significantly 
      lower nocturnal hypoglycaemia rate versus NPH (risk ratio: 0.18; 95% CrI: 0.05 to 
      0.55) and premixed insulin (0.36; 0.14 to 0.94); no significant differences were 
      noted in Gla-300 versus detemir (0.52; 0.19 to 1.36) and degludec (0.66; 0.28 to 
      1.50). Differences in documented symptomatic hypoglycaemia rates of Gla-300 
      versus detemir (0.63; 0.19 to 2.00), NPH (0.66; 0.27 to 1.49) and degludec (0.55; 
      0.23 to 1.34) were not significant. Extensive sensitivity analyses supported the 
      robustness of these findings. CONCLUSIONS: NMA comparisons are useful in the 
      absence of direct randomised controlled data. This NMA suggests that Gla-300 is 
      also associated with a significantly lower risk of nocturnal hypoglycaemia 
      compared with NPH and premixed insulin, with glycaemic control comparable to 
      available basal insulin comparators.
CI  - Published by the BMJ Publishing Group Limited. For permission to use (where not 
      already granted under a licence) please go to 
      http://www.bmj.com/company/products-services/rights-and-licensing/
FAU - Freemantle, Nick
AU  - Freemantle N
AD  - Department of Primary Care and Population Health, University College London, 
      London, UK.
FAU - Chou, Engels
AU  - Chou E
AD  - Global Evidence & Value Development/Health Economics & Outcomes Research, Sanofi, 
      Bridgewater, New Jersey, USA.
FAU - Frois, Christian
AU  - Frois C
AD  - Analysis Group, AG, Boston, Massachusetts, USA.
FAU - Zhuo, Daisy
AU  - Zhuo D
AD  - Analysis Group, AG, Boston, Massachusetts, USA.
FAU - Lehmacher, Walter
AU  - Lehmacher W
AD  - Institute of Medical Statistics, Informatics and Epidemiology, University of 
      Cologne, Cologne, Germany.
FAU - Vlajnic, Aleksandra
AU  - Vlajnic A
AD  - Global Medical Affairs Diabetes, Sanofi, Bridgewater, New Jersey, USA.
FAU - Wang, Hongwei
AU  - Wang H
AD  - Global Evidence & Value Development/Health Economics & Outcomes Research, Sanofi, 
      Bridgewater, New Jersey, USA.
FAU - Chung, Hsing-Wen
AU  - Chung HW
AD  - TechData Service Company, LLC, King of Prussia, Pennsylvania, USA.
FAU - Zhang, Quanwu
AU  - Zhang Q
AD  - Global Evidence & Value Development/Health Economics & Outcomes Research, Sanofi, 
      Bridgewater, New Jersey, USA.
FAU - Wu, Eric
AU  - Wu E
AD  - Analysis Group, AG, Boston, Massachusetts, USA.
FAU - Gerrits, Charles
AU  - Gerrits C
AD  - Global Evidence & Value Development/Health Economics & Outcomes Research, Sanofi, 
      Bridgewater, New Jersey, USA.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PT  - Systematic Review
DEP - 20160215
PL  - England
TA  - BMJ Open
JT  - BMJ open
JID - 101552874
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (Hypoglycemic Agents)
RN  - 2ZM8CX04RZ (Insulin Glargine)
SB  - IM
MH  - Body Weight/drug effects
MH  - Diabetes Mellitus, Type 2/blood/*drug therapy
MH  - Glycated Hemoglobin/metabolism
MH  - Humans
MH  - Hypoglycemia/chemically induced
MH  - Hypoglycemic Agents/*adverse effects/*therapeutic use
MH  - Insulin Glargine/*adverse effects/*therapeutic use
PMC - PMC4762107
OTO - NOTNLM
OT  - DIABETES & ENDOCRINOLOGY
EDAT- 2016/02/18 06:00
MHDA- 2016/11/01 06:00
PMCR- 2016/02/15
CRDT- 2016/02/17 06:00
PHST- 2016/02/17 06:00 [entrez]
PHST- 2016/02/18 06:00 [pubmed]
PHST- 2016/11/01 06:00 [medline]
PHST- 2016/02/15 00:00 [pmc-release]
AID - bmjopen-2015-009421 [pii]
AID - 10.1136/bmjopen-2015-009421 [doi]
PST - epublish
SO  - BMJ Open. 2016 Feb 15;6(2):e009421. doi: 10.1136/bmjopen-2015-009421.