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No increased cancer risk with insulin detemir vs. human insulin
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45th Annual Meeting of the European Association for the Study of Diabetes
Long-acting insulin detemir was not associated with any increase in the incidence of cancer when compared with human insulin, according to new clinical data presented by Novo Nordisk at the meeting.
A meta-analysis of clinical studies of insulin detemir (Levemir, Novo Nordisk) was performed in light of the recent issue surrounding a possible link between insulin glargine therapy and cancer.
The meta-analysis assessed the relative risk for a cancer diagnosis during clinical treatment with insulin detemir. Researchers analyzed data from approximately 9,000 patients included in 21 randomized controlled trials, and compared the incidence of cancer in patients treated with insulin detemir with that of patients treated with either human NPH insulin or insulin glargine (Lantus, Sanofi-Aventis).
Studies that compared insulin detemir with NPH insulin revealed that treatment with insulin detemir was associated with a statistically significant lower incidence of cancer (0.36 events per 100 patient-years vs. 0.92 events per 100 patient-years; P<.05).
The incidence of cancer during insulin detemir treatment was also lower than that seen during treatment with insulin glargine. However, the difference was not statistically significant (0.87 events per 100 patient-years with insulin detemir vs. 1.27 events per 100 patient-years with insulin glargine; P<.05).
“New experimental and clinical data confirm that [insulin detemir] has an excellent safety profile and is not associated with any increase in the incidence of cancer when compared with human insulin,”David Russell-Jones, MD, of the University of Surrey in England, said in a press release. – by Katie Kalvaitis
Although as presented, it appears that insulin detemir is associated with about one-third the cancer risk of insulin glargine and NPH insulin, one must, of course, realize that differences between groups in what amounts to a post-hoc comparison are much less likely to be explained by intrinsic differences between insulin detemir and comparators than by differences in characteristics of the persons making up the different study groups. In an important sense, one must regret the wish of the NovoNordisk investigators, however motivated to defend their product, to present what might be upsetting to persons treated with the other long-acting insulin preparations, rather than waiting for appropriate long-term prospective investigations to address the very important questions of whether the known association of insulin with growth-promoting effects might under certain circumstances lead to adverse effects of treatment with this crucial agent in our therapeutic armamentarium.
– Zachary T. Bloomgarden, MD
Endocrine Today Editorial Board member
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