Comparative clinical efficacy and safety of insulin glargine 300 U/ml (Toujeo) versus insulin glargine 100 U/ml in type 2 diabetes and type 1 diabetes: A systematic literature review and meta‐analysis

Abstract

Aim: To compare the clinical efficacy and safety of glargine-U100 (Lantus/Gla-100) with glargine-U300 (Toujeo/Gla-300) in adult patients with type 2 diabetes (T2D) and type 1 diabetes (T1D). Materials and Methods:A literature search on Gla-300/Gla-100 in diabetes management was conducted using the MEDLINE/Embase/Cochrane databases from inception to 10 January 2021. Eligible studies considered for inclusion were paralleldesign, randomized controlled trials (RCTs). The Cochrane risk-of-bias tool was used to evaluate the quality of the included studies. The random-effects model was applied for interpretation of the results.Results: Of 5348 records screened, 592 were assessed for eligibility and 15 RCTs were considered for data extraction and meta-analysis (T2D [N = 10; n = 7082]; T1D [N = 5; n = 2222]). In patients with T1D, all safety parameters were comparable between Gla-100 and Gla-300. In T2D, statistically significant differences were observed in favour of Gla-300 over Gla-100 for nocturnal and total hypoglycaemia.For efficacy parameters, a statistically and clinically significant difference favouring Gla-100 in basal insulin dose requirement was observed for both T2D and T1D.Change in HbA1c showed a statistically but not clinically significant reduction with Gla-100 compared with Gla-300 in T1D. Statistically significant but clinically less relevant differences favoured Gla-300 for control of body weight in T1D and T2D and Gla-100 for fasting blood glucose in T2D.Conclusions: Gla-100 and Gla-300 had comparable efficacy and safety profiles in both T1D and T2D populations. Gla-300 showed a lower risk of nocturnal and total hypoglycaemia, significant in insulin-experienced/exposed patients with T2D.Patients on Gla-300 required significantly more units of insulin daily than the Gla-100 group to achieve equivalent efficacy.

Ensuring patient safety when managing concentrated insulin glargine and insulin degludec at hospital admission

“…[5][6][7][8] These studies were conducted in the outpatient setting and demonstrated similar reduction in glycated hemoglobin (A1c%) between the two basal insulins, though treatment with iGlar300 resulted in reduced nocturnal hypoglycemia and, in some studies, less hypoglycemia overall. 14,15 iDeg200 was approved based on the findings of the BEGIN trials, which were similarly designed to the EDITION trials.…”

“…iGlar300 was approved based on the success of the EDITION trials, which were phase 3a, open‐label studies comparing iGlar300 and iGlar100 in persons with type 1 or type 2 DM who had varying pharmacotherapy management ranging from insulin‐naive to those on insulin with or without concomitant oral glucose lowering agents 5–8 . These studies were conducted in the outpatient setting and demonstrated similar reduction in glycated hemoglobin (A1c%) between the two basal insulins, though treatment with iGlar300 resulted in reduced nocturnal hypoglycemia and, in some studies, less hypoglycemia overall 14,15 . iDeg200 was approved based on the findings of the BEGIN trials, which were similarly designed to the EDITION trials.…”