scholarly journals An indirect treatment comparison of semaglutide 2.0 mg versus dulaglutide 3.0 mg and 4.5 mg using multilevel network meta-regression

2021 ◽  
Author(s):  
Ildiko Lingvay ◽  
Robert Bauer ◽  
James Baker-Knight ◽  
Jack Lawson ◽  
Richard Pratley
Keyword(s):  
Body Weight ◽  
Credible Interval ◽  
Glycated Haemoglobin ◽  
Sensitivity Analyses ◽  
Indirect Treatment Comparison ◽  
Treatment Comparison ◽  
Reduced Body ◽  
Indirect Treatment ◽  
Meta Regression

Abstract Aims Currently no head-to-head data are available comparing semaglutide 2.0 mg with dulaglutide 3.0 mg or 4.5 mg. We conducted an indirect treatment comparison (ITC) of their effects on glycated haemoglobin (HbA1c) and body weight in patients with type 2 diabetes (T2D). Materials and methods Multilevel network meta-regression (MLNMR) was conducted, based on a connected evidence network of published results from the AWARD-11 trial and individual patient data (IPD) from the SUSTAIN FORTE and SUSTAIN 7 trials. Results Semaglutide 2.0 mg significantly reduced HbA1c versus dulaglutide 3.0 mg and 4.5 mg, with estimated treatment differences (ETD) of –0.44%-points (95% credible interval [CrI]: –0.68, –0.19) and –0.28%-points (95% CrI: –0.52, –0.03), respectively. Semaglutide 2.0 mg also significantly reduced body weight versus dulaglutide 3.0 mg and 4.5 mg with ETDs of –3.29 kg (95% CrI: –4.62, −1.96) and –2.57 kg (95% CrI: –3.90, –1.24), respectively. Odds of achieving HbA1c <7.0% were significantly greater for semaglutide 2.0 versus dulaglutide 3.0 mg (odds ratio [OR]: 2.23 [95% CrI: 1.15, 3.90]), while this did not reach significance for semaglutide 2.0 mg versus dulaglutide 4.5 mg (OR: 1.58 [95% CrI: 0.82, 2.78]). Sensitivity analyses supported the main analysis findings. Conclusions This ITC demonstrated significantly greater reductions from baseline in HbA1c and body weight with semaglutide 2.0 mg vs dulaglutide 3.0 mg and 4.5 mg. The findings of this study provide important comparative effectiveness information until randomised head-to-head studies become available.

scholarly journals Pharmacoeconomic comparison of insulin glargine and insulin detemir in diabetes mellitus type 2

2020 ◽  
pp. 4-14
Author(s):  
I. N. Dyakov ◽  
S. K. Zyryanov
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Glargine ◽  
Effective Control ◽  
Published Data ◽  
Minimal Risk ◽  
Indirect Treatment Comparison ◽  
Treatment Comparison ◽  
Indirect Treatment ◽  
Dm Type 2

Second generation insulin analogue — insulin glargine 300 UI/ml (GLA-300) — can provide an effective control of Diabetes Mellitus (DM) with minimal risk of hypoglycemic events and prevent of cardiovascular complications or events (CVS). Pharmacoeconomic comparison of most used insulins — GLA-300 and detemir (IDet) has been based on indirect treatment comparison in DM Type 2. Materials and methods. Indirect treatment comparison was created according to published data of a real world evidence data for the treatment of DM Type 2 with GLA-300 and IDet, and common comparator — GLA-100 — has been used. Patients (%) who reached HbA1c target were indicated as an efficacy criteria. Odds ratios (OR) were calculated for clinical efficacy and severe hypoglycemia’s rate comparisons for GLA-300 and IDet. Direct (cost of annual treatment, hypoglycemia correction, CVS treatment), indirect medical costs as well as indirect costs (GDP loses) were calculated for GLA-300 and IDet strategies. Sensitivity analysis has been performed for confirmation of the base scenario results. Results. GLA-300 has advantages vs IDet by efficacy and less risks of severe hypoglycemia (OR 1.27 CI 95 % 1.02; 1.58 and OR 0.72 CI 95 % 0.56; 0.88 accordingly). Probability of good control of DM Type 2 (based on target of HbA1c<7.0 %) was higher on 27 % in GLA-300. Costs of insulins, expenditures for CVS treatment and payment for temporary disability were similar for GLA-300 and IDet groups (for the one-year treatment period), in the same time in GLA-300 group the less expenditures for hypoglycemia were observed. Total expenditures were slightly less for GLA-300 on 3.7 % vs IDet.Conclusion. GLA-300 and IDet have no economic advantages between groups in total costs, but GLA-300 has tended for economic benefi ts in compare with IDet in DM Type 2.

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