New insulin glargine 300 U/ml versus glargine 100 U/ml in Japanese people with type 2 diabetes using basal insulin and oral antihyperglycaemic drugs: glucose control and hypoglycaemia in a randomized controlled trial (EDITION JP 2)

AIMS: To compare the efficacy and safety of insulin glargine 300 U/ml (Gla‐300) with glargine 100 U/ml (Gla‐100) in Japanese people with type 2 diabetes using basal insulin plus oral antihyperglycaemic drug(s) [OAD(s)]. METHODS: The EDITION JP 2 study (NCT01689142) was a 6‐month, multicentre, open‐label, phase III study. Participants (n = 241, male 61%, mean diabetes duration 14 years, mean weight 67 kg, mean body mass index 25 kg/m(2), mean glycated haemoglobin (HbA1c) 8.02 %, mean basal insulin dose 0.24 U/kg/day) were randomized to Gla‐300 or Gla‐100, while continuing OAD(s). Basal insulin was titrated to target fasting self‐monitored plasma glucose 4.4−5.6 mmol/l. The primary efficacy endpoint was HbA1c change over 6 months. Safety endpoints included hypoglycaemia and weight change. RESULTS: Gla‐300 was non‐inferior to Gla‐100 for HbA1c reduction [least squares (LS) mean difference 0.10 (95% confidence interval [CI] −0.08, 0.27) %]. The mean HbA1c at month 6 was 7.56 and 7.52 % with Gla‐300 and Gla‐100, respectively. Nocturnal confirmed (≤3.9 mmol/l) or severe hypoglycaemia risk was 38% lower with Gla‐300 versus Gla‐100 [relative risk 0.62 (95% CI 0.44, 0.88)]; annualized rates were 55% lower at night [rate ratio 0.45 (95% CI 0.21, 0.96)] and 36% lower at any time [24 h; rate ratio 0.64 (95% CI 0.43, 0.96)]. Severe hypoglycaemia was infrequent. A significant between‐treatment difference in weight change favoured Gla‐300 [LS mean difference −1.0 (95% CI −1.5, −0.5) kg; p = 0.0003]. Adverse event rates were comparable between groups. CONCLUSIONS: Japanese people with type 2 diabetes using basal insulin plus OAD(s) experienced less hypoglycaemia with Gla‐300 than with Gla‐100, while glycaemic control did not differ.