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Comparison of lixisenatide in combination with basal insulin vs other insulin regimens for the treatment of patients with type 2 diabetes inadequately controlled by basal insulin: Systematic review, network meta-analysis and cost-effectiveness analysis.
Diabetes Obes Metab. 2020 01; 22(1):107-115.DO

Abstract

AIMS

To evaluate the comparative efficacy and safety of lixisenatide combined with basal insulin (BI) vs intensive premix insulin (premix), BI plus prandial insulin with the main meal (basal-plus) or progressively covering all meals (basal-bolus) in patients with type 2 diabetes mellitus (T2DM) inadequately controlled by BI, and the long-term cost-effectiveness of lixisenatide from a Chinese healthcare system perspective.

MATERIALS AND METHODS

Randomized controlled trials (RCTs) published between 1998 and 2018 were systematically searched. The clinical efficacy and safety of each treatment were compared by network meta-analysis (NMA). The IQVIA CORE Diabetes Model was used to estimate the lifetime quality-adjusted life-years (QALYs) and direct medical costs of patients treated with different strategies.

RESULTS

Eight RCTs were finally included. Lixisenatide plus BI showed a similar reduction in HbA1c from baseline compared with premix, basal-plus and basal-bolus. There were significant differences in the change of body weight in favour of lixisenatide plus BI compared with the three insulin regimens. The risk of symptomatic hypoglycaemia of lixisenatide plus BI was significantly lower compared with premix and basal-bolus. Lixisenatide plus BI was cost-effective compared with premix, basal-plus and basal-bolus with incremental cost-effectiveness ratios of Chinese yuan (CNY) 87 219, 48 173 and 48 670 per QALY gained, respectively, under the threshold of three times the gross domestic product (GDP) per capita in China.

CONCLUSIONS

Lixisenatide plus BI shows a similar HbA1c reduction compared with insulin regimens, accompanied by lower risk of hypoglycaemia and greater body weight reduction. It is a cost-effective treatment alternative for patients with T2DM inadequately controlled by BI in China.

Authors+Show Affiliations

Department of Pharmacy, Peking University Third Hospital, Beijing, China. Institute for Drug Evaluation, Peking University Health Science Center, Beijing, China.Real World Insights, IQVIA, Shanghai, China.Real World Insights, IQVIA, Shanghai, China.Health Economics & Outcome Research, Shanghai, China.Department of Pharmacy, Peking University Third Hospital, Beijing, China. Institute for Drug Evaluation, Peking University Health Science Center, Beijing, China.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

31469217

Citation

Men, Peng, et al. "Comparison of Lixisenatide in Combination With Basal Insulin Vs Other Insulin Regimens for the Treatment of Patients With Type 2 Diabetes Inadequately Controlled By Basal Insulin: Systematic Review, Network Meta-analysis and Cost-effectiveness Analysis." Diabetes, Obesity & Metabolism, vol. 22, no. 1, 2020, pp. 107-115.
Men P, Qu S, Luo W, et al. Comparison of lixisenatide in combination with basal insulin vs other insulin regimens for the treatment of patients with type 2 diabetes inadequately controlled by basal insulin: Systematic review, network meta-analysis and cost-effectiveness analysis. Diabetes Obes Metab. 2020;22(1):107-115.
Men, P., Qu, S., Luo, W., Li, C., & Zhai, S. (2020). Comparison of lixisenatide in combination with basal insulin vs other insulin regimens for the treatment of patients with type 2 diabetes inadequately controlled by basal insulin: Systematic review, network meta-analysis and cost-effectiveness analysis. Diabetes, Obesity & Metabolism, 22(1), 107-115. https://doi.org/10.1111/dom.13871
Men P, et al. Comparison of Lixisenatide in Combination With Basal Insulin Vs Other Insulin Regimens for the Treatment of Patients With Type 2 Diabetes Inadequately Controlled By Basal Insulin: Systematic Review, Network Meta-analysis and Cost-effectiveness Analysis. Diabetes Obes Metab. 2020;22(1):107-115. PubMed PMID: 31469217.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of lixisenatide in combination with basal insulin vs other insulin regimens for the treatment of patients with type 2 diabetes inadequately controlled by basal insulin: Systematic review, network meta-analysis and cost-effectiveness analysis. AU - Men,Peng, AU - Qu,Shuli, AU - Luo,Wenting, AU - Li,Chaoyun, AU - Zhai,Suodi, Y1 - 2019/10/07/ PY - 2019/03/13/received PY - 2019/08/08/revised PY - 2019/08/28/accepted PY - 2019/8/31/pubmed PY - 2019/8/31/medline PY - 2019/8/31/entrez KW - antidiabetic drug KW - cost-effectiveness KW - glucagon-like peptide-1 analogue KW - insulin therapy KW - network meta-analysis KW - systematic review SP - 107 EP - 115 JF - Diabetes, obesity & metabolism JO - Diabetes Obes Metab VL - 22 IS - 1 N2 - AIMS: To evaluate the comparative efficacy and safety of lixisenatide combined with basal insulin (BI) vs intensive premix insulin (premix), BI plus prandial insulin with the main meal (basal-plus) or progressively covering all meals (basal-bolus) in patients with type 2 diabetes mellitus (T2DM) inadequately controlled by BI, and the long-term cost-effectiveness of lixisenatide from a Chinese healthcare system perspective. MATERIALS AND METHODS: Randomized controlled trials (RCTs) published between 1998 and 2018 were systematically searched. The clinical efficacy and safety of each treatment were compared by network meta-analysis (NMA). The IQVIA CORE Diabetes Model was used to estimate the lifetime quality-adjusted life-years (QALYs) and direct medical costs of patients treated with different strategies. RESULTS: Eight RCTs were finally included. Lixisenatide plus BI showed a similar reduction in HbA1c from baseline compared with premix, basal-plus and basal-bolus. There were significant differences in the change of body weight in favour of lixisenatide plus BI compared with the three insulin regimens. The risk of symptomatic hypoglycaemia of lixisenatide plus BI was significantly lower compared with premix and basal-bolus. Lixisenatide plus BI was cost-effective compared with premix, basal-plus and basal-bolus with incremental cost-effectiveness ratios of Chinese yuan (CNY) 87 219, 48 173 and 48 670 per QALY gained, respectively, under the threshold of three times the gross domestic product (GDP) per capita in China. CONCLUSIONS: Lixisenatide plus BI shows a similar HbA1c reduction compared with insulin regimens, accompanied by lower risk of hypoglycaemia and greater body weight reduction. It is a cost-effective treatment alternative for patients with T2DM inadequately controlled by BI in China. SN - 1463-1326 UR - https://www.unboundmedicine.com/medline/citation/31469217/Comparison_of_lixisenatide_in_combination_with_basal_insulin_vs_other_insulin_regimens_for_the_treatment_of_patients_with_type_2_diabetes_inadequately_controlled_by_basal_insulin:_Systematic_review_network_meta_analysis_and_cost_effectiveness_analysis_ L2 - https://doi.org/10.1111/dom.13871 DB - PRIME DP - Unbound Medicine ER -
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