Initiating insulin glargine
Use the preferred brand ABASAGLAR (insulin glargine) 100 units/mL solution for injection in cartridge & pre-filled pen
ABASAGLAR is a biosimilar medicinal product. A biosimilar medicine is a biological medicine that is developed to be highly similar and clinically equivalent to an existing biological medicine. A biosimilar contains a version of an active substance of an already approved biological medicine, which is referred to as the ‘reference medicine’. Similarity to the reference medicine in terms of quality, structural characteristics, biological activity, safety and efficacy must be established; for insulin glargine biosimilar (Abasaglar) in two randomised controlled trials showed equivalence to insulin glargine (Lantus) at reducing HbA1c levels in people with type1 and type2 diabetes. Abasaglar is licensed for the treatment of diabetes mellitus in adults, adolescents and children aged 2 years and above.
Remember to initiate NPH (Isophane) Insulin when indicated for type 2 diabetics and ONLY use long acting analogues-insulin glargine (Abasaglar) (in place of NPH) if patient needs help with injections and frequency needs to be reduced from twice to once daily, patient suffers frequent hypoglycaemic attacks that significantly affect quality of life or would need to have two insulin injections and continue oral anti-diabetic medication to achieve control.
Initiation of Abasaglar insulin in type 1 & 2 diabetes for adults and children ≥ 2yrs
· When once-daily insulin glargine is indicated offer Abasaglar for patients requiring glargine for the first time.
· Always prescribe insulin by brand so that the patient gets the intended preparation each time.
· Refer to local guidelines for the use of Insulin in Type 1 and Type 2 Diabetes for insulin insulin glargine’s place in therapy.
· Abasaglar insulin is available as kwik pens and cartridges
· Remember to prescribe re-usable pens for patients requiring cartridges (Humapen Savvio as standard. For patients requiring half unit dosing prescribe Humapen Luxura).
Please note that the Abasaglar device is not the same as that of the originator (Lantus). Abasaglar cartridges cannot be used in the re-useable pen devices produced for Lantus.
References
· NICE ESNM64 (2015) ‘Diabetes mellitus type 1 and type 2: insulin glargine biosimilar (Abasaglar)’, available at: https://www.nice.org.uk/advice/esnm64/chapter/Key-points-from-the-evidence (accessed: 02/08/2016)
· NICE KTT15 (2016) ‘Biosimilar medicines’, available at: https://www.nice.org.uk/advice/ktt15 (accessed:02/08/2016)
· Medicines Q&As (2013) ‘Which medicines should be considered for brand-name prescribing in primary care’, available at: UKMi (accessed: 02/08/2016)
· Eli Lilly and Company Limited (2015) ‘ABASAGLAR 100 units/mL solution for injection in cartridge & pre-filled pen’, available at: https://www.medicines.org.uk/emc/medicine/30494 (accessed:02/08/2016)
Authors: North East Essex Diabetes Services and North East Essex Medicines Management Committee
August 2016 Review date: August 2018