Efficiency of Gla-300 versus Gla-100 Across Age Groups in People Living with Type 2 Diabetes in France: A Post Hoc Analysis of an Observational Longitudinal Study.

IF 4 3区 医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL
Patrice Darmon, Olivier Hanon, Pierre Gourdy, Isabelle Borget, Bruno Detournay, Pierre Evenou, Isabelle Bureau, Noemie Allali, Aymeric Mahieu, Corinne Emery, Alfred Penfornis
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Abstract

Introduction: The EF-BI study, a nationwide observational and retrospective study conducted in France, found better insulin persistence, fewer insulin therapy-related acute hospitalizations, and lower healthcare costs in adults with Type 2 diabetes (T2D) who initiated treatment with insulin glargine 300 U/mL (Gla-300) compared to those who started on insulin glargine 100 U/mL (Gla-100) over a 3-year follow-up period. Given the heterogeneity of the T2D population, the benefits observed may vary according to individuals' characteristics. A post hoc analysis of this study was conducted to verify whether these findings were consistent in all age groups, including the elderly population.

Methods: Using the French national health insurance information system, adults with T2D who initiated basal insulin therapy with Gla-300 or Gla-100 between January 1, 2016, and December 31, 2020, and had no prior insulin use in the previous 6 months, were selected. Covariate adjustment using a propensity score based on key individuals' characteristics was applied to estimate outcomes and costs between the two basal insulins. Analyses were conducted using several age cut-offs (65, 75, and 80 years).

Results: Overall, 235,894 people with T2D were included: 175,537 initiated treatments with Gla-100 and 60,357 with Gla-300. Across both age groups (< 65 years or older), treatment with Gla-300 was associated with better persistence and a lower frequency of acute insulin-related events. Cost comparisons per individual treated over 3 years showed significant results favoring Gla-300:- €2,031 (- 7.3%, p < 0.0001) in the < 65 years group, and- €2,914 (- 7%, p < 0.0001) in the older group.

Conclusion: This EF-BI post hoc analysis found that Gla-300 was associated with lower overall costs, better persistence, and fewer insulin-related acute events compared to Gla-100 in several age subgroups in people with T2D in France. Further investigations are needed to confirm these results, including glycemic control and comparison with other second-generation basal insulins.

Gla-300与Gla-100在法国2型糖尿病患者中跨年龄组的疗效:一项观察性纵向研究的事后分析
EF-BI研究是在法国进行的一项全国性的观察性和回顾性研究,在3年的随访期内发现,与开始使用甘精胰岛素100 U/mL (Gla-100)治疗的2型糖尿病(T2D)患者相比,开始使用甘精胰岛素300 U/mL (Gla-300)治疗的患者胰岛素耐受性更好,胰岛素治疗相关的急性住院率更低,医疗费用更低。鉴于T2D人群的异质性,观察到的益处可能因个体特征而异。对这项研究进行了事后分析,以验证这些发现是否在所有年龄组(包括老年人)中都是一致的。方法:使用法国国家健康保险信息系统,选择在2016年1月1日至2020年12月31日期间开始使用Gla-300或Gla-100进行基础胰岛素治疗的成人T2D患者,并且在过去6个月内没有使用过胰岛素。使用基于关键个体特征的倾向评分进行协变量调整,以估计两种基础胰岛素之间的结果和成本。分析采用了几个年龄界限(65岁、75岁和80岁)。结果:总体而言,235,894例T2D患者被纳入:175,537例开始接受Gla-100治疗,60,357例开始接受Gla-300治疗。结论:EF-BI事后分析发现,在法国几个年龄亚组的T2D患者中,与Gla-100相比,Gla-300具有更低的总成本、更好的持久性和更少的胰岛素相关急性事件。需要进一步的研究来证实这些结果,包括血糖控制和与其他第二代基础胰岛素的比较。
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来源期刊
Advances in Therapy
Advances in Therapy 医学-药学
CiteScore
7.20
自引率
2.60%
发文量
353
审稿时长
6-12 weeks
期刊介绍: Advances in Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all therapeutic areas. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Advances in Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.
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