A Systematic Literature Review and Network Meta Analysis of Insulin Icodec With Other Basal Insulins in Patients With Type 2 Diabetes Switching From Basal-Bolus 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 outcomes of insulin icodec with other basal insulins for the management of patients with type 2 diabetes (T2D) switching basal insulin in a basal-bolus regimen, 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) 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 resulted in numerically greater HbA1c reductions compared with insulin detemir, with a treatment difference of −0.27% (95% credible interval [Crl]; −0.56, 0.02]), and numerically lower HbA1c reductions compared with IGlar U100 (0.02% [95% Crl; −0.12, 0.16]) and IGlar U300 (0.04% [95% Crl; −0.14, 0.22]). No comparable HbA1c data were available for change from baseline in HbA1c at 26 ± 4 weeks with insulin degludec. Treatment with insulin icodec resulted in numerically lower odds of clinically significant hypoglycaemia compared with IGlar U100 (odds ratio, 0.85 [95% Crl; 0.61, 1.17]), and numerically greater odds of clinically significant hypoglycaemia compared with IGlar U300 (odds ratio, 1.04 [95% Crl; 0.68, 1.60]). No comparable data were available for clinically significant hypoglycaemia at 26 ± 4 weeks with insulin detemir.
CONCLUSIONS: For patients with T2D switching basal insulin in a basal-bolus regimen, insulin icodec resulted in no significant change in HbA1c, or proportion of patients experiencing clinically significant hypoglycaemic events, at 26 ± 4 weeks compared with other basal insulins.
Conference/Value in Health Info
Value in Health, Volume 27, Issue 12, S2 (December 2024)
Code
CO148
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