Toujeo press release

[uvula]

Sanofi put out a press release comparing toujeo to other base insulins. Am I reading this correctly? The avg t2 on toujeo has an a1c of 8.33 and 5.1% have hypos. It doesn't mention what if any mealtime insulin was used.

[Deleted]

Can you provide the link?

[mnkdfann]

Jun 11, 2016 22:27:33 GMT -5 mango said:

Can you provide the link?

I just googled 'Sanofi' and it came right up. Here you go:

www.stockhouse.com/news/press-releases/2016/06/11/successful-switch-to-sanofi-s-toujeo-evaluated-in-a-real-world-setting

EXCERPT:

Adults with type 2 diabetes who had used other basal insulins within the 6 months prior to Toujeo initiation (one or more prescription order of Toujeo between March 2015 and December 2015) were identified. The PHIE records of those identified (N=881) were assessed for HbA1c and incidence of confirmed (≤70 mg/dL) or severe hypoglycemia up to 6 months prior to and up to 6 months after initiation.

Among the subpopulation of patients (n=267) with HbA1c measured at baseline and during follow-up (0-6 months), mean HbA1c was 8.97% at baseline and 8.33% at follow-up. For the subpopulation of patients (n=449) with occurrence of hypoglycemia measured at baseline and during follow-up (0-3 months), this was 6.0% at baseline and 5.1% at follow-up.

[Deleted]

Thanks. My search Windows are maxed out and just wanted to bookmark the thread so I can read it later.

[mnkdfann]

Jun 11, 2016 21:13:27 GMT -5 uvula said:

Sanofi put out a press release comparing toujeo to other base insulins. Am I reading this correctly? The avg t2 on toujeo has an a1c of 8.33 and 5.1% have hypos. It doesn't mention what if any mealtime insulin was used.

I don't really understand the significance. So occurrence of hypoglycemia measured at baseline and during follow-up (0-3 months) was 6.0% at baseline and 5.1% at follow-up.

What are the accepted rates?

I googled the topic and found this one article (link below) that says "occurrence of hypoglycemia was monitored in a cohort of 267 people with insulin-treated diabetes (both type 1 and type 2) over a period of 1 month (81). The prevalence of all hypoglycemia (mild and severe) in the group with insulin-treated type 2 diabetes was 45%".

Compared to that, it sounds like the Toujeo results are pretty fantastic.

But I really don't understand the details.

Anyone?

care.diabetesjournals.org/content/28/12/2948

[agedhippie]

Jun 11, 2016 22:43:34 GMT -5 mnkdfann said:

Jun 11, 2016 21:13:27 GMT -5 uvula said:

Sanofi put out a press release comparing toujeo to other base insulins. Am I reading this correctly? The avg t2 on toujeo has an a1c of 8.33 and 5.1% have hypos. It doesn't mention what if any mealtime insulin was used.

I don't really understand the significance. So occurrence of hypoglycemia measured at baseline and during follow-up (0-3 months) was 6.0% at baseline and 5.1% at follow-up.

What are the accepted rates?

I googled the topic and found this one article (link below) that says "occurrence of hypoglycemia was monitored in a cohort of 267 people with insulin-treated diabetes (both type 1 and type 2) over a period of 1 month (81). The prevalence of all hypoglycemia (mild and severe) in the group with insulin-treated type 2 diabetes was 45%".

Compared to that, it sounds like the Toujeo results are pretty fantastic.

But I really don't understand the details.

Anyone?

care.diabetesjournals.org/content/28/12/2948

It's a typical screwed up press release. I am willing to bet that their hypoglycemia numbers are not consistent with the paper. Mild hypoglycemia is anything below 70 and you could believe 45% hit that once a month. The PR doesn't define what they mean by a hypo but I expect it's a lot lower than 70, probably 55 which is the next marker for hypos.

Yes, with that A1c they should have their basal adjusted because it's probably wrong and if that doesn't work then meal time insulin. That's the standard of care. Part of the problem is that people with Type 2 start on basal insulin and never adjust it with time as the diabetes progresses. Their doctors should really fix that but that often doesn't happen ("you are on insulin that's all we can do") which is wrong.

[dg1111]

A quick check of Afrezza User"s blog (that hasn't been updated in a year) shows that Afrezza user's A1Cs are almost all in the 6s with some 5s. I am not sure what the hypo rate is, but it doesn't seem like you much, if anything, about those. So I guess my question is, why would Sanofi publish this? The numbers don't seem that good. Maybe I have some bitterness, because they could have bragged about better numbers with Afrezza, and they didn't.

[cm5]

See this abstract, to place above in context:  bmjopen.bmj.com/content/6/2/e009421.full

Safety and efficacy of insulin glargine 300 u/mL compared with other basal insulin therapies in patients with type 2 diabetes mellitus: a network meta-analysis
Nick Freemantle1, Engels Chou2, Christian Frois3, Daisy Zhuo3, Walter Lehmacher4, Aleksandra Vlajnic5, Hongwei Wang2, Hsing-wen Chung6, Quanwu Zhang2, Eric Wu3, Charles Gerrits2
1Department of Primary Care and Population Health, University College London, London, UK
2Global Evidence & Value Development/Health Economics & Outcomes Research, Sanofi, Bridgewater, New Jersey, USA
3Analysis Group, AG, Boston, Massachusetts, USA
4Institute of Medical Statistics, Informatics and Epidemiology, University of Cologne, Cologne, Germany
5Global Medical Affairs Diabetes, Sanofi, Bridgewater, New Jersey, USA
6TechData Service Company, LLC, King of Prussia, Pennsylvania, USA
Correspondence to
Dr Nick Freemantle; [e-mail]
Published 15 February 2016

Abstract

Objective To compare the efficacy and safety of a concentrated formulation of insulin glargine (Gla-300) with other basal insulin therapies in patients with type 2 diabetes mellitus (T2DM).

Design This was a network meta-analysis (NMA) of randomised clinical trials of basal insulin therapy in T2DM identified via a systematic literature review of Cochrane library databases, MEDLINE and MEDLINE In-Process, EMBASE and PsycINFO.

Outcome measures Changes in HbA1c (%) and body weight, and rates of nocturnal and documented symptomatic hypoglycaemia were assessed.

Results 41 studies were included; 25 studies comprised the main analysis population: patients on basal insulin-supported oral therapy (BOT). Change in glycated haemoglobin (HbA1c) was comparable between Gla-300 and detemir (difference: −0.08; 95% credible interval (CrI): −0.40 to 0.24), neutral protamine Hagedorn (NPH; 0.01; −0.28 to 0.32), degludec (−0.12; −0.42 to 0.20) and premixed insulin (0.26; −0.04 to 0.58). Change in body weight was comparable between Gla-300 and detemir (0.69; −0.31 to 1.71), NPH (−0.76; −1.75 to 0.21) and degludec (−0.63; −1.63 to 0.35), but significantly lower compared with premixed insulin (−1.83; −2.85 to −0.75).

Gla-300 was associated with a significantly lower nocturnal hypoglycaemia rate versus NPH (risk ratio: 0.18; 95% CrI: 0.05 to 0.55) and premixed insulin (0.36; 0.14 to 0.94); no significant differences were noted in Gla-300 versus detemir (0.52; 0.19 to 1.36) and degludec (0.66; 0.28 to 1.50). Differences in documented symptomatic hypoglycaemia rates of Gla-300 versus detemir (0.63; 0.19to 2.00), NPH (0.66; 0.27 to 1.49) and degludec (0.55; 0.23 to 1.34) were not significant. Extensive sensitivity analyses supported the robustness of these findings.

Conclusions NMA comparisons are useful in the absence of direct randomised controlled data. This NMA suggests that Gla-300 is also associated with a significantly lower risk of nocturnal hypoglycaemia compared with NPH and premixed insulin, with glycaemic control comparable to available basal insulin comparators.

[uvula]

Jun 12, 2016 10:26:19 GMT -5 dg1111 said:

A quick check of Afrezza User"s blog (that hasn't been updated in a year) shows that Afrezza user's A1Cs are almost all in the 6s with some 5s. I am not sure what the hypo rate is, but it doesn't seem like you much, if anything, about those. So I guess my question is, why would Sanofi publish this? The numbers don't seem that good. Maybe I have some bitterness, because they could have bragged about better numbers with Afrezza, and they didn't.

Many people here are claiming toujeo is worse than lantus. I'm guessing sanofi was thrilled that they were able to claim that toujeo is even slightly better than something else.

[rch51]

Jun 12, 2016 10:26:19 GMT -5 dg1111 said:

A quick check of Afrezza User"s blog (that hasn't been updated in a year) shows that Afrezza user's A1Cs are almost all in the 6s with some 5s. I am not sure what the hypo rate is, but it doesn't seem like you much, if anything, about those. So I guess my question is, why would Sanofi publish this? The numbers don't seem that good. Maybe I have some bitterness, because they could have bragged about better numbers with Afrezza, and they didn't.

Apples and Oranges.  Basal insulin is considered long acting and almost always injected. Afrezza is a Prandial Insulin, used for post-meal glucose spikes.

[Deleted]

Didn't their stock price take a hit this week

[sportsrancho]

Jun 12, 2016 16:14:16 GMT -5 @reverselo said:

Didn't their stock price take a hit this week

Some one I know does nothing but trade SNY. Buys at 38 and sells at 42. (Look at the one year chart.)

[agedhippie]

Jun 12, 2016 16:31:37 GMT -5 sportsrancho said:

Jun 12, 2016 16:14:16 GMT -5 @reverselo said:

Didn't their stock price take a hit this week

Some one I know does nothing but trade SNY. Buys at 38 and sells at 42. (Look at the one year chart.)

Oooh I love those. Off to look at the chart....

[hillsave]

The reduction of 8% is no big deal. Especially when you are starting at almost 9%. My A1c went from 6.4 to 5.7 in 7 months on Afrezza only. That's over 10%. The higher the starting point the easier it is to have a higher percentage drop.

[uvula]

Doctors and press release writers often get a1c and "reduction in a1c" confused. 8% could mean an a1c of 8 or a reduction in a1c of 8%.