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Lixisenatide for Type 2 Diabetes Mellitus Patients Inadequately Controlled on Oral Antidiabetic Drugs: A Mixed-Treatment Comparison Meta-analysis and Cost-Utility Analysis.
Diabetes Ther. 2020 Aug; 11(8):1745-1755.DT

Abstract

INTRODUCTION

The aim of this study was to compare the efficacy, safety and cost-utility (from the Chinese health insurance perspective) of lixisenatide and insulin regimens in patients with type 2 diabetes mellitus (T2DM) inadequately controlled on oral antidiabetic drugs (OADs).

METHODS

A comprehensive literature search of English (PubMed and Cochrane Library) and Chinese (CNKI and WanFang) language databases was performed, and head-to-head relevant randomized controlled trials (RCTs) were retrieved and analyzed by performing a mixed-treatment comparison (MTC) meta-analysis for efficacy and safety endpoints. A cost-utility analysis was then conducted using the IQVIA CORE Diabetes Model to compare the lifetime pharmacoeconomic profiles among the treatment groups.

RESULTS

Eleven RCTs were included in this MTC meta-analysis. Regarding glycated hemoglobin targets, lixisenatide was similar to both basal insulin (mean difference [MD] 0.27%; 95% credible interval [CrI] 0.02%, 0.57%) and premixed insulin (MD 0.32%; 95% CrI - 0.01%, 0.66%), respectively. Statistically significant differences were found for changes in body weight in favor of lixisenatide compared with basal insulin (MD - 3.22 kg; 95% CrI - 5.51 kg, - 0.94 kg) and premixed insulin (MD - 2.68 kg; 95% CrI - 5.16 kg, - 0.20 kg). The relative risk (RR) of symptomatic hypoglycemia associated with lixisenatide was also significantly lower than that associated with basal insulin (RR 0.22; 95% CrI 0.09, 0.52) and premixed insulin (RR 0.17; 95% CrI 0.07, 0.41). The cost-utility analysis yielded results of ¥61,072 ($8565, vs. basal insulin) and ¥127,169 ($17,836, vs. premixed insulin) per quality-adjusted life year gained, with both values falling within the willingness-to-pay threshold in China.

CONCLUSIONS

For T2DM patients inadequately controlled on OADs, lixisenatide was shown to be comparable to basal insulin and premixed insulin in terms of HbA1c and better than both of the latter in terms of both body weight loss and hypoglycemia. Lixisenatide was also a cost-effective treatment option from the perspective of Chinese health insurance.

Authors+Show Affiliations

Department of Pharmacy, Peking University Third Hospital, Beijing, 100191, China. Institute for Drug Evaluation, Peking University Health Science Center, Beijing, 100191, China.Real-World Insights Division, IQVIA, Shanghai, 200041, China.Tianjin Medical University Chu Hisen-I Memorial Hospital, Tianjin, 300134, China.Real-World Insights Division, IQVIA, Shanghai, 200041, China.Health Economics and Outcome Research, Sanofi, Shanghai, 200040, China.Department of Pharmacy, Peking University Third Hospital, Beijing, 100191, China. zhaisuodi@163.com. Institute for Drug Evaluation, Peking University Health Science Center, Beijing, 100191, China. zhaisuodi@163.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32562244

Citation

Men, Peng, et al. "Lixisenatide for Type 2 Diabetes Mellitus Patients Inadequately Controlled On Oral Antidiabetic Drugs: a Mixed-Treatment Comparison Meta-analysis and Cost-Utility Analysis." Diabetes Therapy : Research, Treatment and Education of Diabetes and Related Disorders, vol. 11, no. 8, 2020, pp. 1745-1755.
Men P, Qu S, Song Z, et al. Lixisenatide for Type 2 Diabetes Mellitus Patients Inadequately Controlled on Oral Antidiabetic Drugs: A Mixed-Treatment Comparison Meta-analysis and Cost-Utility Analysis. Diabetes Ther. 2020;11(8):1745-1755.
Men, P., Qu, S., Song, Z., Liu, Y., Li, C., & Zhai, S. (2020). Lixisenatide for Type 2 Diabetes Mellitus Patients Inadequately Controlled on Oral Antidiabetic Drugs: A Mixed-Treatment Comparison Meta-analysis and Cost-Utility Analysis. Diabetes Therapy : Research, Treatment and Education of Diabetes and Related Disorders, 11(8), 1745-1755. https://doi.org/10.1007/s13300-020-00857-3
Men P, et al. Lixisenatide for Type 2 Diabetes Mellitus Patients Inadequately Controlled On Oral Antidiabetic Drugs: a Mixed-Treatment Comparison Meta-analysis and Cost-Utility Analysis. Diabetes Ther. 2020;11(8):1745-1755. PubMed PMID: 32562244.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Lixisenatide for Type 2 Diabetes Mellitus Patients Inadequately Controlled on Oral Antidiabetic Drugs: A Mixed-Treatment Comparison Meta-analysis and Cost-Utility Analysis. AU - Men,Peng, AU - Qu,Shuli, AU - Song,Zhenqiang, AU - Liu,Yanjun, AU - Li,Chaoyun, AU - Zhai,Suodi, Y1 - 2020/06/19/ PY - 2020/05/09/received PY - 2020/6/21/pubmed PY - 2020/6/21/medline PY - 2020/6/21/entrez KW - Chinese KW - Economics KW - GLP-1 analogue KW - Network meta-analysis KW - Type 2 diabetes SP - 1745 EP - 1755 JF - Diabetes therapy : research, treatment and education of diabetes and related disorders JO - Diabetes Ther VL - 11 IS - 8 N2 - INTRODUCTION: The aim of this study was to compare the efficacy, safety and cost-utility (from the Chinese health insurance perspective) of lixisenatide and insulin regimens in patients with type 2 diabetes mellitus (T2DM) inadequately controlled on oral antidiabetic drugs (OADs). METHODS: A comprehensive literature search of English (PubMed and Cochrane Library) and Chinese (CNKI and WanFang) language databases was performed, and head-to-head relevant randomized controlled trials (RCTs) were retrieved and analyzed by performing a mixed-treatment comparison (MTC) meta-analysis for efficacy and safety endpoints. A cost-utility analysis was then conducted using the IQVIA CORE Diabetes Model to compare the lifetime pharmacoeconomic profiles among the treatment groups. RESULTS: Eleven RCTs were included in this MTC meta-analysis. Regarding glycated hemoglobin targets, lixisenatide was similar to both basal insulin (mean difference [MD] 0.27%; 95% credible interval [CrI] 0.02%, 0.57%) and premixed insulin (MD 0.32%; 95% CrI - 0.01%, 0.66%), respectively. Statistically significant differences were found for changes in body weight in favor of lixisenatide compared with basal insulin (MD - 3.22 kg; 95% CrI - 5.51 kg, - 0.94 kg) and premixed insulin (MD - 2.68 kg; 95% CrI - 5.16 kg, - 0.20 kg). The relative risk (RR) of symptomatic hypoglycemia associated with lixisenatide was also significantly lower than that associated with basal insulin (RR 0.22; 95% CrI 0.09, 0.52) and premixed insulin (RR 0.17; 95% CrI 0.07, 0.41). The cost-utility analysis yielded results of ¥61,072 ($8565, vs. basal insulin) and ¥127,169 ($17,836, vs. premixed insulin) per quality-adjusted life year gained, with both values falling within the willingness-to-pay threshold in China. CONCLUSIONS: For T2DM patients inadequately controlled on OADs, lixisenatide was shown to be comparable to basal insulin and premixed insulin in terms of HbA1c and better than both of the latter in terms of both body weight loss and hypoglycemia. Lixisenatide was also a cost-effective treatment option from the perspective of Chinese health insurance. SN - 1869-6953 UR - https://www.unboundmedicine.com/medline/citation/32562244/Lixisenatide_for_Type_2_Diabetes_Mellitus_Patients_Inadequately_Controlled_on_Oral_Antidiabetic_Drugs:_A_Mixed-Treatment_Comparison_Meta-analysis_and_Cost-Utility_Analysis L2 - https://dx.doi.org/10.1007/s13300-020-00857-3 DB - PRIME DP - Unbound Medicine ER -
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