Impact of Background Antihyperglycemic Therapy on Insulin Glargine 300 U/mL (Gla-300) vs. Insulin Degludec 100 U/mL (IDeg-100) in Insulin-Naïve People with T2DM from the BRIGHT Randomized Study
Authors: ROUSSEL RONAN , ROSENSTOCK JULIO , PETTUS JEREMY , RITZEL ROBERT , CHENG ALICE , BOSNYAK ZSOLT , DEVISME CHRISTINE , CALI ANNA M. , WANG XIANGLING , BOLLI GEREMIA B. 
Published: June 2018

BRIGHT (NCT02738151), the first head-to-head trial of Gla-300 and IDeg-100 in T2DM, is a multicenter, open-label, randomized, parallel-group, 24-week actively controlled study, conducted in insulin-naïve participants uncontrolled on current antihyperglycemic drugs. Participants (mean baseline HbA1c 8.6%, diabetes duration 10.6 years, BMI 31.5 kg/m2) received Gla-300 (N=466) or IDeg-100 (N=463), titrated to a fasting SMPG of 80-100 mg/dL, and remained on metformin ± previous antihyperglycemic therapy. Primary endpoint: change in HbA1c from baseline to week 24; safety endpoints included hypoglycemia incidence. Here we report HbA1c and hypoglycemia outcomes by background antihyperglycemic therapy (no comparisons were performed for metformin as it was received by 92% of participants). Overall distribution of background therapy was: SU/Glinides (65.7%/2.3%), DPP-4i (24.4%), SGLT2i (13.3%), GLP-1 RA (11.9%). No evidence of heterogeneity of treatment effect according to use of background antihyperglycemic therapy on HbA1c reductions (Table), or incidence of confirmed (≤70 mg/dL or &lt;54 mg/dL) or severe hypoglycemia was shown (all p&gt;0.05).
In conclusion, background antihyperglycemic therapies had no impact on the comparable efficacy and hypoglycemia profiles of Gla-300 and IDeg-100.

Disclosure
R. Roussel: Advisory Panel; Self; AbbVie Inc., Abbott, Eli Lilly and Company, Sanofi, Novo Nordisk A/S, AstraZeneca. Speaker's Bureau; Self; Servier. Consultant; Self; Bayer AG. Advisory Panel; Self; Merck Sharp & Dohme Corp.. Research Support; Self; Amgen Inc., Sanofi, Novo Nordisk A/S, Danone Research. Stock/Shareholder; Self; Iriade. Advisory Panel; Self; Physiogenex S.A.S. J. Rosenstock: Advisory Panel; Self; Eli Lilly and Company. Consultant; Self; Eli Lilly and Company. Research Support; Self; Novo Nordisk Inc.. Consultant; Self; Novo Nordisk Inc.. Advisory Panel; Self; Sanofi. Consultant; Self; Sanofi. Advisory Panel; Self; Janssen Pharmaceuticals, Inc.. Consultant; Self; Janssen Pharmaceuticals, Inc.. Advisory Panel; Self; Boehringer Ingelheim Pharmaceuticals, Inc.. Consultant; Self; Boehringer Ingelheim Pharmaceuticals, Inc.. Advisory Panel; Self; Intarcia Therapeutics, Inc.. Consultant; Self; Intarcia Therapeutics, Inc.. Research Support; Self; Merck & Co., Inc., Pfizer Inc., Sanofi, Novo Nordisk Inc., Bristol-Myers Squibb Company, Eli Lilly and Company, Intarcia Therapeutics, Inc., Genentech, Inc. J. Pettus: Advisory Panel; Self; Sanofi, Novo Nordisk Inc.. Consultant; Self; MannKind Corporation. Advisory Panel; Self; Insulet Corporation. Consultant; Self; Senseonics. R. Ritzel: Speaker's Bureau; Self; AstraZeneca. Consultant; Self; Novo Nordisk A/S. Speaker's Bureau; Self; Novo Nordisk A/S. Consultant; Self; Sanofi. Speaker's Bureau; Self; Sanofi. Consultant; Self; Servier. Speaker's Bureau; Self; Bristol-Myers Squibb Company, Merck Sharp & Dohme Corp., Boehringer Ingelheim GmbH, Eli Lilly and Company, Novartis Pharmaceuticals Corporation. A. Cheng: Advisory Panel; Self; Abbott. Speaker's Bureau; Self; Abbott. Advisory Panel; Self; AstraZeneca. Speaker's Bureau; Self; AstraZeneca. Advisory Panel; Self; Boehringer Ingelheim GmbH. Speaker's Bureau; Self; Boehringer Ingelheim GmbH. Advisory Panel; Self; Eli Lilly and Company. Speaker's Bureau; Self; Eli Lilly and Company. Advisory Panel; Self; Janssen Pharmaceuticals, Inc.. Speaker's Bureau; Self; Janssen Pharmaceuticals, Inc.. Advisory Panel; Self; Merck & Co., Inc.. Speaker's Bureau; Self; Merck & Co., Inc.. Advisory Panel; Self; Novo Nordisk A/S. Speaker's Bureau; Self; Novo Nordisk A/S. Advisory Panel; Self; Sanofi. Speaker's Bureau; Self; Sanofi. Consultant; Self; Takeda Canada Inc.. Research Support; Self; Sanofi, Boehringer Ingelheim GmbH. Z. Bosnyak: Employee; Self; Sanofi. Stock/Shareholder; Self; Sanofi. C. Devisme: Employee; Self; Sanofi. Stock/Shareholder; Self; Sanofi. A.M. Cali: Employee; Self; Sanofi. Stock/Shareholder; Self; Sanofi. X. Wang: Employee; Self; Sanofi. Stock/Shareholder; Self; Sanofi. G.B. Bolli: Speaker's Bureau; Self; Menarini Group, Sanofi. Research Support; Self; Sanofi.