Insulin lispro 25/75 and insulin lispro 50/50 as starter insulin in Japanese patients with type 2 diabetes: subanalysis of the CLASSIFY randomized trial
In Japan, premixed insulins are commonly used as starter insulin for type 2 diabetes. This subpopulation analysis assessed the efficacy and safety of twice-daily LM25 (25% insulin lispro/75% insulin lispro protamine) and LM50 (50% insulin lispro/50% insulin lispro protamine) as starter insulin in Ja...
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| Veröffentlicht in: | Endocrine Journal 2017, Vol.64(7), pp.705-717 |
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| creator | Watada, Hirotaka Imori, Makoto Li, Pengfei Iwamoto, Noriyuki |
| description | In Japan, premixed insulins are commonly used as starter insulin for type 2 diabetes. This subpopulation analysis assessed the efficacy and safety of twice-daily LM25 (25% insulin lispro/75% insulin lispro protamine) and LM50 (50% insulin lispro/50% insulin lispro protamine) as starter insulin in Japanese subjects, and compared these results with the whole-trial populations of East Asian subjects. In this subpopulation analysis of an open-label, phase 4, randomized trial (CLASSIFY), Japanese subjects received LM25 (n = 88) or LM50 (n = 84) twice-daily for 26 weeks. The primary outcome was change from baseline at Week 26 in glycated hemoglobin (HbA1c). Results for Japanese subjects were generally similar to those for the whole-trial population. Similar changes from baseline in HbA1c were observed for LM25 and LM50 groups (least squares [LS] mean difference [95% confidence interval] of LM25 - LM50 = 0.13 [-0.16, 0.41]%, 1.42 [-1.75, 4.48] mmol/mol, p = 0.388). More LM50-treated subjects than LM25-treated subjects achieved HbA1c targets of |
| doi_str_mv | 10.1507/endocrj.EJ17-0020 |
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This subpopulation analysis assessed the efficacy and safety of twice-daily LM25 (25% insulin lispro/75% insulin lispro protamine) and LM50 (50% insulin lispro/50% insulin lispro protamine) as starter insulin in Japanese subjects, and compared these results with the whole-trial populations of East Asian subjects. In this subpopulation analysis of an open-label, phase 4, randomized trial (CLASSIFY), Japanese subjects received LM25 (n = 88) or LM50 (n = 84) twice-daily for 26 weeks. The primary outcome was change from baseline at Week 26 in glycated hemoglobin (HbA1c). Results for Japanese subjects were generally similar to those for the whole-trial population. Similar changes from baseline in HbA1c were observed for LM25 and LM50 groups (least squares [LS] mean difference [95% confidence interval] of LM25 - LM50 = 0.13 [-0.16, 0.41]%, 1.42 [-1.75, 4.48] mmol/mol, p = 0.388). More LM50-treated subjects than LM25-treated subjects achieved HbA1c targets of <7.0% (59.5% versus 43.2%; p = 0.034) or ≤6.5% (45.2% versus 28.4%; p = 0.027). The reduction in postprandial blood glucose concentrations after morning and evening meals was statistically significantly greater for LM50 than for LM25. The incidence of both hypoglycemia and treatment-emergent adverse events were similar between treatment groups. Both LM25 and LM50 twice daily appear to be effective and well tolerated as starter insulin, although LM50 might be more effective for Japanese type 2 diabetes patients.</description><identifier>ISSN: 0918-8959</identifier><identifier>EISSN: 1348-4540</identifier><identifier>DOI: 10.1507/endocrj.EJ17-0020</identifier><identifier>PMID: 28539526</identifier><language>eng</language><publisher>Japan: The Japan Endocrine Society</publisher><subject><![CDATA[Aged ; Asian Continental Ancestry Group ; Biphasic Insulins - administration & dosage ; Biphasic Insulins - adverse effects ; Biphasic Insulins - therapeutic use ; Blood glucose ; Blood Glucose - analysis ; Diabetes ; Diabetes mellitus ; Diabetes mellitus (non-insulin dependent) ; Diabetes Mellitus, Type 2 - blood ; Diabetes Mellitus, Type 2 - drug therapy ; Diabetes Mellitus, Type 2 - ethnology ; Drug Administration Schedule ; Far East - epidemiology ; Female ; Glucose ; Glycated Hemoglobin A - analysis ; Hemoglobin ; Humans ; Hyperglycemia - prevention & control ; Hypoglycemia ; Hypoglycemia - chemically induced ; Hypoglycemia - epidemiology ; Hypoglycemia - prevention & control ; Hypoglycemic Agents - administration & dosage ; Hypoglycemic Agents - adverse effects ; Hypoglycemic Agents - therapeutic use ; Incidence ; Insulin ; Insulin lispro ; Insulin Lispro - administration & dosage ; Insulin Lispro - adverse effects ; Insulin Lispro - therapeutic use ; Insulin Resistance - ethnology ; Insulin, Isophane - administration & dosage ; Insulin, Isophane - adverse effects ; Insulin, Isophane - therapeutic use ; Japan ; Japan - epidemiology ; Male ; Middle Aged ; Patients ; Postprandial Period ; Premixed insulin ; Protamine]]></subject><ispartof>Endocrine Journal, 2017, Vol.64(7), pp.705-717</ispartof><rights>The Japan Endocrine Society</rights><rights>Copyright Japan Science and Technology Agency 2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c526t-be17b8e51da0213534c8d1d8515e9f296b44cdbb011cb2af85f7d9ee052652173</citedby><cites>FETCH-LOGICAL-c526t-be17b8e51da0213534c8d1d8515e9f296b44cdbb011cb2af85f7d9ee052652173</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,1883,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28539526$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Watada, Hirotaka</creatorcontrib><creatorcontrib>Imori, Makoto</creatorcontrib><creatorcontrib>Li, Pengfei</creatorcontrib><creatorcontrib>Iwamoto, Noriyuki</creatorcontrib><title>Insulin lispro 25/75 and insulin lispro 50/50 as starter insulin in Japanese patients with type 2 diabetes: subanalysis of the CLASSIFY randomized trial</title><title>Endocrine Journal</title><addtitle>Endocr J</addtitle><description>In Japan, premixed insulins are commonly used as starter insulin for type 2 diabetes. This subpopulation analysis assessed the efficacy and safety of twice-daily LM25 (25% insulin lispro/75% insulin lispro protamine) and LM50 (50% insulin lispro/50% insulin lispro protamine) as starter insulin in Japanese subjects, and compared these results with the whole-trial populations of East Asian subjects. In this subpopulation analysis of an open-label, phase 4, randomized trial (CLASSIFY), Japanese subjects received LM25 (n = 88) or LM50 (n = 84) twice-daily for 26 weeks. The primary outcome was change from baseline at Week 26 in glycated hemoglobin (HbA1c). Results for Japanese subjects were generally similar to those for the whole-trial population. Similar changes from baseline in HbA1c were observed for LM25 and LM50 groups (least squares [LS] mean difference [95% confidence interval] of LM25 - LM50 = 0.13 [-0.16, 0.41]%, 1.42 [-1.75, 4.48] mmol/mol, p = 0.388). More LM50-treated subjects than LM25-treated subjects achieved HbA1c targets of <7.0% (59.5% versus 43.2%; p = 0.034) or ≤6.5% (45.2% versus 28.4%; p = 0.027). The reduction in postprandial blood glucose concentrations after morning and evening meals was statistically significantly greater for LM50 than for LM25. The incidence of both hypoglycemia and treatment-emergent adverse events were similar between treatment groups. Both LM25 and LM50 twice daily appear to be effective and well tolerated as starter insulin, although LM50 might be more effective for Japanese type 2 diabetes patients.</description><subject>Aged</subject><subject>Asian Continental Ancestry Group</subject><subject>Biphasic Insulins - administration & dosage</subject><subject>Biphasic Insulins - adverse effects</subject><subject>Biphasic Insulins - therapeutic use</subject><subject>Blood glucose</subject><subject>Blood Glucose - analysis</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Diabetes mellitus (non-insulin dependent)</subject><subject>Diabetes Mellitus, Type 2 - blood</subject><subject>Diabetes Mellitus, Type 2 - drug therapy</subject><subject>Diabetes Mellitus, Type 2 - ethnology</subject><subject>Drug Administration Schedule</subject><subject>Far East - epidemiology</subject><subject>Female</subject><subject>Glucose</subject><subject>Glycated Hemoglobin A - analysis</subject><subject>Hemoglobin</subject><subject>Humans</subject><subject>Hyperglycemia - prevention & control</subject><subject>Hypoglycemia</subject><subject>Hypoglycemia - chemically induced</subject><subject>Hypoglycemia - epidemiology</subject><subject>Hypoglycemia - prevention & control</subject><subject>Hypoglycemic Agents - administration & dosage</subject><subject>Hypoglycemic Agents - adverse effects</subject><subject>Hypoglycemic Agents - therapeutic use</subject><subject>Incidence</subject><subject>Insulin</subject><subject>Insulin lispro</subject><subject>Insulin Lispro - administration & dosage</subject><subject>Insulin Lispro - adverse effects</subject><subject>Insulin Lispro - therapeutic use</subject><subject>Insulin Resistance - ethnology</subject><subject>Insulin, Isophane - administration & dosage</subject><subject>Insulin, Isophane - adverse effects</subject><subject>Insulin, Isophane - therapeutic use</subject><subject>Japan</subject><subject>Japan - epidemiology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Patients</subject><subject>Postprandial Period</subject><subject>Premixed insulin</subject><subject>Protamine</subject><issn>0918-8959</issn><issn>1348-4540</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkcGO0zAQhi0EYsvCA3BBlrhwyXZsx03CbVXtLl1V4rBw4GQ58YS6SpPgcYTKk_C4uGqJBJJlH-abf_zPz9hbATdCQ7HE3g1N2N_cPYoiA5DwjC2Eysss1zk8ZwuoRJmVla6u2CuiPYBSOlcv2ZUstaq0XC3Y701PU-d73nkaw8ClXhaa295x_29Bw1IDt8Qp2hAxzPV0Hu1oeyTko40e-0j8p487Ho8jcsmdtzVGpI-cptr2tjuSJz60PO6Qr7e3T0-b-288pJnDwf9Cx2PwtnvNXrS2I3xzea_Z1_u7L-tP2fbzw2Z9u82a9P-Y1SiKukQtnAUplFZ5UzrhSi00Vq2sVnWeN66uQYimlrYtdVu4ChFSt5aiUNfsw1k3mfwxIUVz8NRg1yVHw0RGVCDzEioQCX3_H7ofppAMkZEg0s4VaJ0ocaaaMBAFbM0Y_MGGoxFgTrGZS2zmFJs5xZZ63l2Up_qAbu74m1MCHs7APq3_O85AisI3Hc6Sq9wUp2uWnolmZ0PC1B_4U644</recordid><startdate>20170101</startdate><enddate>20170101</enddate><creator>Watada, Hirotaka</creator><creator>Imori, Makoto</creator><creator>Li, Pengfei</creator><creator>Iwamoto, Noriyuki</creator><general>The Japan Endocrine Society</general><general>Japan Science and Technology Agency</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7T5</scope><scope>7TK</scope><scope>8FD</scope><scope>FR3</scope><scope>H94</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope></search><sort><creationdate>20170101</creationdate><title>Insulin lispro 25/75 and insulin lispro 50/50 as starter insulin in Japanese patients with type 2 diabetes: subanalysis of the CLASSIFY randomized trial</title><author>Watada, Hirotaka ; Imori, Makoto ; Li, Pengfei ; Iwamoto, Noriyuki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c526t-be17b8e51da0213534c8d1d8515e9f296b44cdbb011cb2af85f7d9ee052652173</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Aged</topic><topic>Asian Continental Ancestry Group</topic><topic>Biphasic Insulins - administration & dosage</topic><topic>Biphasic Insulins - adverse effects</topic><topic>Biphasic Insulins - therapeutic use</topic><topic>Blood glucose</topic><topic>Blood Glucose - analysis</topic><topic>Diabetes</topic><topic>Diabetes mellitus</topic><topic>Diabetes mellitus (non-insulin dependent)</topic><topic>Diabetes Mellitus, Type 2 - blood</topic><topic>Diabetes Mellitus, Type 2 - drug therapy</topic><topic>Diabetes Mellitus, Type 2 - ethnology</topic><topic>Drug Administration Schedule</topic><topic>Far East - epidemiology</topic><topic>Female</topic><topic>Glucose</topic><topic>Glycated Hemoglobin A - analysis</topic><topic>Hemoglobin</topic><topic>Humans</topic><topic>Hyperglycemia - prevention & control</topic><topic>Hypoglycemia</topic><topic>Hypoglycemia - chemically induced</topic><topic>Hypoglycemia - epidemiology</topic><topic>Hypoglycemia - prevention & control</topic><topic>Hypoglycemic Agents - administration & dosage</topic><topic>Hypoglycemic Agents - adverse effects</topic><topic>Hypoglycemic Agents - therapeutic use</topic><topic>Incidence</topic><topic>Insulin</topic><topic>Insulin lispro</topic><topic>Insulin Lispro - administration & dosage</topic><topic>Insulin Lispro - adverse effects</topic><topic>Insulin Lispro - therapeutic use</topic><topic>Insulin Resistance - ethnology</topic><topic>Insulin, Isophane - administration & dosage</topic><topic>Insulin, Isophane - adverse effects</topic><topic>Insulin, Isophane - therapeutic use</topic><topic>Japan</topic><topic>Japan - epidemiology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Patients</topic><topic>Postprandial Period</topic><topic>Premixed insulin</topic><topic>Protamine</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Watada, Hirotaka</creatorcontrib><creatorcontrib>Imori, Makoto</creatorcontrib><creatorcontrib>Li, Pengfei</creatorcontrib><creatorcontrib>Iwamoto, Noriyuki</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Endocrine Journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Watada, Hirotaka</au><au>Imori, Makoto</au><au>Li, Pengfei</au><au>Iwamoto, Noriyuki</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Insulin lispro 25/75 and insulin lispro 50/50 as starter insulin in Japanese patients with type 2 diabetes: subanalysis of the CLASSIFY randomized trial</atitle><jtitle>Endocrine Journal</jtitle><addtitle>Endocr J</addtitle><date>2017-01-01</date><risdate>2017</risdate><volume>64</volume><issue>7</issue><spage>705</spage><epage>717</epage><pages>705-717</pages><issn>0918-8959</issn><eissn>1348-4540</eissn><abstract>In Japan, premixed insulins are commonly used as starter insulin for type 2 diabetes. This subpopulation analysis assessed the efficacy and safety of twice-daily LM25 (25% insulin lispro/75% insulin lispro protamine) and LM50 (50% insulin lispro/50% insulin lispro protamine) as starter insulin in Japanese subjects, and compared these results with the whole-trial populations of East Asian subjects. In this subpopulation analysis of an open-label, phase 4, randomized trial (CLASSIFY), Japanese subjects received LM25 (n = 88) or LM50 (n = 84) twice-daily for 26 weeks. The primary outcome was change from baseline at Week 26 in glycated hemoglobin (HbA1c). Results for Japanese subjects were generally similar to those for the whole-trial population. Similar changes from baseline in HbA1c were observed for LM25 and LM50 groups (least squares [LS] mean difference [95% confidence interval] of LM25 - LM50 = 0.13 [-0.16, 0.41]%, 1.42 [-1.75, 4.48] mmol/mol, p = 0.388). More LM50-treated subjects than LM25-treated subjects achieved HbA1c targets of <7.0% (59.5% versus 43.2%; p = 0.034) or ≤6.5% (45.2% versus 28.4%; p = 0.027). The reduction in postprandial blood glucose concentrations after morning and evening meals was statistically significantly greater for LM50 than for LM25. The incidence of both hypoglycemia and treatment-emergent adverse events were similar between treatment groups. Both LM25 and LM50 twice daily appear to be effective and well tolerated as starter insulin, although LM50 might be more effective for Japanese type 2 diabetes patients.</abstract><cop>Japan</cop><pub>The Japan Endocrine Society</pub><pmid>28539526</pmid><doi>10.1507/endocrj.EJ17-0020</doi><tpages>13</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Endocrine Journal, 2017, Vol.64(7), pp.705-717 |
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| source | J-STAGE (Free - Japanese); MEDLINE; EZB-FREE-00999 freely available EZB journals |
| subjects | Aged Asian Continental Ancestry Group Biphasic Insulins - administration & dosage Biphasic Insulins - adverse effects Biphasic Insulins - therapeutic use Blood glucose Blood Glucose - analysis Diabetes Diabetes mellitus Diabetes mellitus (non-insulin dependent) Diabetes Mellitus, Type 2 - blood Diabetes Mellitus, Type 2 - drug therapy Diabetes Mellitus, Type 2 - ethnology Drug Administration Schedule Far East - epidemiology Female Glucose Glycated Hemoglobin A - analysis Hemoglobin Humans Hyperglycemia - prevention & control Hypoglycemia Hypoglycemia - chemically induced Hypoglycemia - epidemiology Hypoglycemia - prevention & control Hypoglycemic Agents - administration & dosage Hypoglycemic Agents - adverse effects Hypoglycemic Agents - therapeutic use Incidence Insulin Insulin lispro Insulin Lispro - administration & dosage Insulin Lispro - adverse effects Insulin Lispro - therapeutic use Insulin Resistance - ethnology Insulin, Isophane - administration & dosage Insulin, Isophane - adverse effects Insulin, Isophane - therapeutic use Japan Japan - epidemiology Male Middle Aged Patients Postprandial Period Premixed insulin Protamine |
| title | Insulin lispro 25/75 and insulin lispro 50/50 as starter insulin in Japanese patients with type 2 diabetes: subanalysis of the CLASSIFY randomized trial |
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