A Systematic Literature Review and Network Meta Analysis of Insulin Icodec With Other Basal Insulins in Patients With Type 2 Diabetes Switching From Basal Insulin Regimens
Author(s)
Bøg M1, LeReun C2, Gupta P3, Chubb B4, Jensen MS5, Nair S6
1Novo Nordisk A/S, Søborg, 85, Denmark, 2Clarivate Analytics Ltd, London, UK, 3Clarivate Analytics Ltd, Bangalore, India, 4Novo Nordisk A/S, Gatwick, UK, 5Novo Nordisk A/S, Søborg, Denmark, 6Clarivate Analytics Ltd, Mumbai, MH, India
OBJECTIVES: A network meta-analysis (NMA) was conducted to compare the efficacy and safety of insulin icodec with other basal insulins for the management of patients with type 2 diabetes (T2D) switching from basal insulin, based on studies identified through a systematic literature review (SLR).
METHODS: A SLR was conducted in October 2023 to identify relevant randomised controlled trials (RCTs) examining treatments of interest (insulin icodec, insulin glargine [IGlar U100, IGlar U300], insulin detemir, and insulin degludec [U100 and U200]) in this population. Data at 26 ± 4 weeks were extracted for efficacy and safety outcomes including change from baseline in glycated haemoglobin (HbA1c) and proportion of patients with clinically significant hypoglycaemic events. Fixed- and random-effects NMA were fitted in a Bayesian setting.
RESULTS: Treatment with insulin icodec was associated with significantly greater HbA1c reductions compared with insulin degludec U100, (−0.22% [95% credible interval {Crl}; −0.37, −0.08]), and numerically greater HbA1c reductions compared with insulin degludec U200 (−0.11% [95% Crl; −0.33, 0.11]), and IGlar U100 (−0.17% (95% Crl; -0.44, 0.10) and U300 (−0.16% [95% Crl; −0.39, 0.07]). Treatment with insulin icodec was associated with significantly higher odds of clinically significant hypoglycaemia compared with insulin degludec U100 (odds ratio, 2.13 [95% Crl; 1.20, 3.91]), and numerically higher odds compared with insulin degludec U200 (odds ratio, 1.93 [95% Crl; 0.95, 4.01]). No comparable data were available for change from baseline in HbA1c with insulin detemir, or for proportion of patients with clinically significant hypoglycaemic events with IGlar U100, U300, or insulin detemir.
CONCLUSIONS: For patients with T2D switching from basal insulin, insulin icodec resulted in greater HbA1c reductions at 26 ± 4 weeks compared with other basal analogs. Insulin icodec was associated with an increased risk of hypoglycaemic events compared with two comparators. However, data for hypoglycaemic events was limited.
Conference/Value in Health Info
Value in Health, Volume 27, Issue 12, S2 (December 2024)
Code
CO110
Topic
Clinical Outcomes, Study Approaches
Topic Subcategory
Comparative Effectiveness or Efficacy, Literature Review & Synthesis, Meta-Analysis & Indirect Comparisons
Disease
Diabetes/Endocrine/Metabolic Disorders (including obesity), No Additional Disease & Conditions/Specialized Treatment Areas