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Positive results in Phase 3 trial for Toujeo® in children and adolescents with type 1 diabetes

By Editor
5th November 2019
Paediatrics, Pharmaceutical

Children and adolescents with type 1 diabetes achieved comparable reduction in HbA1c and similar risk of low blood sugar events with Toujeo® (insulin glargine 300 Units/mL) compared to insulin glargine 100 Units/mL (Gla-100), according to new research.

The study covered people aged 6 to 17 years and the results were presented at the International Society for Pediatric and Adolescent Diabetes 45thAnnual Conference in Boston, Massachusetts.

Professor Thomas Danne, Director of the Department of General Pediatrics and Endocrinology/Diabetology at the Children’s Hospital on the Bult, Hannover Medical School, Germany, said: “We know that living with type 1 diabetes means dealing with highs and lows in blood sugar, which are worrying and present substantial challenges for young people. In addition to the trial demonstrating safety and efficacy, the percentage of patients with severe hypoglycaemia, and the percentage with hyperglycemia with ketosis, were numerically lower with Toujeo.”

The trial, EDITION JUNIOR, is the first randomized, controlled trial comparing Toujeo vs Gla-100 in this group of patients. The study met its primary endpoint with comparable reductions in average blood sugar over six months with both treatments and similar risk of hypoglycaemia. The percentages of participants who experienced severe hypoglycaemia and who experienced high blood sugar (hyperglycemia) with ketosis were numerically lower with Toujeo, according to the results.

Based on these data, the European Medicines Agency’s Committee for Medicinal Products for Human Use adopted a positive opinion on October 17, recommending expanding the current indication for Toujeo in the Europe Union for the treatment of diabetes mellitus in adolescents and children (six years and older).

Dietmar Berger, Global Head of Development at Sanofi, said: “Across the globe, between 50 and 80 percent of young people living with type 1 diabetes need more treatment options to help them achieve an average blood sugar level below 7.5%. By taking this step toward investigating an additional option for children and adolescents living with diabetes, we hope to provide another treatment for them and their physicians, to develop an individualized treatment plan that helps patients better manage their disease.”

The European Commission will make a final decision on this additional indication in the coming months.

About the study

The EDITION JUNIOR study1 compared Toujeo to Gla-100 in 463 children and adolescents (aged 6 to 17 years) treated for type 1 diabetes for at least one year and with Hb between 7.5% and 11.0% at screening. Participants continued to use their existing mealtime insulin.

The study met its primary endpoint, confirming non-inferior reduction of HbA1c with Toujeo vs Gla-100 after 26 weeks (mean reduction 0.4% vs 0.4%; difference: 0.004%, 95% CI -0.17 to 0.18; upper bound was below the pre-specified non-inferiority margin of 0.3%).

Over the same period, a comparable number of patients experienced one or more anytime (24 hours) documented low blood sugar (hypoglycaemia) events. Numerically fewer patients using Toujeo experienced severe hypoglycaemia, or experienced one or more episodes of high blood sugar (hyperglycemia) with ketosis compared, with those using Gla-100.

The number of adverse events was comparable between the two treatment groups (65.2% vs 65.8% of patients reported any treatment-emergent adverse event). No unexpected safety concerns were reported, based on the established profiles of both products.

Toujeo
(n=233)
Gla-100
(n=228)
One or more event of severe and/or documented (≤ 70 mg/dL) hypoglycaemia (24 h) 226 (97%) 223 (97.8%)
RR: 0.99
95% CI: 0.96 to 1.02
One or more event of severe and/or documented (< 54 mg/dL) hypoglycaemia (24 h) 187 (80.3%) 191 (83.8%)
RR: 0.96
95% CI: 0.88 to 1.04
One or more episode of severe hypoglycaemia (24 h) 14 (6.0%) 20 (8.8%)
RR: 0.68
95% CI (0.35 to 1.30)
One or more event of hyperglycaemia with ketosis (ketones ≥1.5 mmol/L) 19 (8.2%) 26 (11.4%)

The study design includes a further six-month safety follow-up period, which will be reported separately.

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