Humalog(R) Mix(TM) 75/25 vs Lantus(R) in Type 2 Diabetes
June 05 2004 - 11:00AM
PR Newswire (US)
Humalog(R) Mix(TM) 75/25 vs Lantus(R) in Type 2 Diabetes Study
Results Unveiled at the American Diabetes Association Annual
Scientific Sessions INDIANAPOLIS, June 5 /PRNewswire-FirstCall/ --
When people are first diagnosed with type 2 diabetes -- the most
common form of diabetes -- they are often treated with diet and
exercise and/or oral medications. Over time, as the disease
progresses, patients frequently require insulin therapy. In two
separate studies comparing Humalog(R) Mix75/25(TM) to Lantus(R),
the former did a better job than the latter of helping patients
with type 2 diabetes lower their blood sugar levels and achieve
better diabetes control over time. Humalog Mix75/25 (75% insulin
lispro protamine suspension, 25% insulin lispro injection [rDNA
origin]) is an insulin analog mixture. Lantus (insulin glargine
[rDNA origin] injection) is a basal insulin analog. "Maintaining
control of blood sugar is important for all patients with diabetes
in order to prevent the onset of debilitating and sometimes fatal
diabetes-related complications, such as stroke and heart disease,"
said James Malone, M.D., who was involved in conducting both
studies and is a diabetes medical director at Eli Lilly and
Company, which developed Humalog Mix75/25. "These studies indicate
the benefit of a twice-daily insulin analog mixture on achieving
and maintaining improved glucose control specifically in patients
with type 2 diabetes." In both of these open label studies, blood
sugar, or glucose, levels were measured via a glycosylated
hemoglobin test (A1C), a standard test used by healthcare
professionals when treating patients with diabetes. An A1C shows a
patient's "average" blood sugar level over the previous two or
three months, thereby giving an overall picture of his or her
diabetes control. Both studies compared the responses of
twice-daily Humalog Mix75/25 plus metformin (a commonly-prescribed
oral medication for type 2 diabetes) to once- daily Lantus plus
metformin on A1C levels, post-meal blood glucose levels and overall
rates of hypoglycemia (low blood sugar). Managing glucose levels,
including post-meal glucose levels, is critical to diabetes
control. Study one consisted of 105 patients in the United States
with type 2 diabetes who were new to insulin therapy. Participants
received 32 weeks of treatment -- 16 weeks with each insulin
(Humalog Mix72/25 and Lantus, though not necessarily in that order)
plus metformin. According to the results, which were presented
today at the annual meeting of the American Diabetes Association
(ADA) Scientific Sessions in Orlando, Fla.: * A1C results were
significantly improved in both groups, but the improvement was
greater for Humalog Mix75/25. -- The A1C at endpoint was the
primary objective of this study. The average A1C at endpoint for
Humalog Mix75/25 was 7.4 percent and for Lantus 7.8 percent. -- On
average, A1C results dropped 1.3 percent when patients received
Humalog Mix75/25. By comparison, when patients received Lantus,
their A1C results dropped an average of 0.9 percent. * At the
study's conclusion, 41 percent of patients treated with Humalog
Mix75/25 achieved an A1C level of seven percent or lower. The ADA
recommends a target A1C of less than 7.0 percent. Twenty-two
percent of patients on Lantus achieved an A1C level of seven
percent or lower at the end of the study. * Humalog Mix75/25 was
associated with a smaller rise in glucose levels after participants
ate breakfast and dinner meals. -- The average rise in
post-breakfast glucose level for Humalog Mix75/25 was 18 mg/dL
compared to 47 mg/dL for Lantus. -- The average rise in post-dinner
glucose level was 14 mg/dL for Humalog Mix75/25 and 40 mg/dL for
Lantus. * After 16 weeks of treatment, patients taking Lantus had
lower rates of hypoglycemia compared to those treated with Humalog
Mix75/25. On average, patients treated with Lantus had .39 episodes
per month compared to .68 episodes per month for those on Humalog
Mix75/25. No instances of severe hypoglycemia were reported in
either study arm. -- Among participants, the rate of hypoglycemia
during sleep was similar after 16 weeks of treatment with each
insulin (.14 episodes per patient per month with Humalog Mix75/25
vs. .24 episodes per patient per month with Lantus). Study two
consisted of 97 patients from Europe whose blood sugar was not
under control despite treatment with insulin therapy once or twice
a day, or insulin in combination with oral medications. All
patients were treated with bedtime NPH plus metformin for a
six-week lead-in period, so that apples could be compared to
apples, so to speak. As in study one, participants received 32
weeks of treatment -- 16 weeks each with Humalog Mix75/25 and
Lantus. Both insulins were given with metformin. Results of study
two showed: * The A1C at endpoint was the primary objective of this
study. The average A1C at endpoint for Humalog Mix75/25 was 7.5
percent and for Lantus 8.1 percent. * On average, patients treated
with Humalog Mix75/25 showed a greater reduction in A1C levels
compared to those same patients treated with Lantus (1 percent vs.
0.42 percent respectively). * At the study's conclusion, 30 percent
of patients on Humalog Mix75/25 achieved a target A1C level of
seven percent or lower, compared to 12 percent on Lantus. * On
average, the increase in glucose levels after all three main meals
(breakfast, lunch and dinner) were 27 mg/dL lower among patients
treated with Humalog Mix75/25 compared to Lantus. As expected,
fasting blood glucose levels were lower in the Lantus group (the
average was 127 mg/dL for Lantus and 140 mg/dL for Humalog
Mix75/25). * Overall hypoglycemia rates were not significantly
different between either treatment arm and no instances of severe
hypoglycemia were reported in either group. -- However, on average,
patients treated with Humalog Mix75/25 had fewer episodes of
hypoglycemia during sleep than those patients on Lantus (.14
episodes per patients per month compared to .34 episodes per
patients per month). "These data are further evidence of the
benefit of using a pre-mixed insulin at mealtimes compared with
once-daily insulin," said John Holcombe, M.D., a diabetes medical
advisor at Lilly. "Moreover, the results of this study support the
growing body of evidence that suggests controlling blood sugar
levels at mealtimes is important in achieving overall improved
glycemic control in patients with type 2 diabetes." About Humalog
Mix75/25 Humalog Mix75/25 is for use in patients with diabetes to
control high blood sugar. Humalog Mix75/25 starts lowering blood
glucose more quickly than regular human insulin, allowing for
convenient dosing immediately before a meal (within 15 minutes). By
combining the benefits of the rapid-acting Humalog with an
intermediate-acting insulin, Humalog Mix75/25 provides blood
glucose control throughout the day -- at mealtime, between meals
and at nighttime. It is available by prescription only. Humalog
Mix75/25 is not indicated for use with metformin. Important Safety
Information Potential side effects associated with the use of all
insulins include low blood sugar, weight gain, low blood potassium,
changes in fat tissue at the side of injection and allergic
reactions, both general and local. Humalog Mix75/25 should not be
mixed with another insulin. Starting or changing insulin therapy
should be done cautiously and only under medical supervision. For
full prescribing information on Humalog Mix75/25 go to
http://www.humalog.com/ or call 1-800-LILLYRX. For full prescribing
information on Lantus, go to http://www.lantus.com/ . About Eli
Lilly and Company Lilly, a leading innovation-driven corporation,
is developing a growing portfolio of first-in-class and
best-in-class pharmaceutical products by applying the latest
research from its own worldwide laboratories and from
collaborations with eminent scientific organizations. Headquartered
in Indianapolis, Ind., Lilly provides answers -- through medicines
and information -- for some of the world's most urgent medical
needs. Additional information about Lilly is available at
http://www.lilly.com/ . Humalog(R) Mix75/25(TM) (75% insulin lispro
protamine suspension, 25% insulin lispro injection [rDNA origin],
Lilly) Lantus(R) (insulin glargine [rDNA origin] injection),
Aventis Pharmaceuticals) (Logo:
http://www.newscom.com/cgi-bin/prnh/20031219/LLYLOGO )
http://www.newscom.com/cgi-bin/prnh/20031219/LLYLOGO DATASOURCE:
Eli Lilly and Company CONTACT: Meg Wanick of MS&L, cell phone:
+1-415-265-1785; or Judy Kay Moore of Lilly, office phone:
+1-317-277-6265
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