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ORIGIN: Cancer incidence, mortality rates unaffected by insulin glargine
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CHICAGO — Results of the cancer substudy of the ORIGIN trial demonstrate that the effect of insulin glargine on overall and cancer-specific mortality was neutral. Additionally, metformin and HbA1c levels did not affect cancer risk, according to Louise Bordeleau, MD, MSc, FRCP, who presented results here at the ADA Scientific Sessions.
“Based on the ORIGIN trial, daily exposure to insulin glargine for a median of 6.2 years had a neutral effect on cancer events, including any cancer, new or recurrent cancers, cancer related mortality and various types of cancers,” Bordeleau, who is associate professor in the department of oncology at McMaster University, said. “Cancer events were not modulated by the use of metformin with or without sulfonylureas, by HbA1c on trial or weight.”
Cancer incidence and cancer mortality according to randomization comprised the primary endpoints of the cancer substudy. Secondary endpoints included the association between cancer outcomes and glycemic control and glucose lowering therapies.
During a median follow-up of 6.2 years, 953 patients (7.6% of the 12,537 patients included in the study) had a cancer event (1.32 per 100 person-years in both the glargine and standard groups), according to data. These patients were older, had a higher frequency of smoking and alcohol intake, a previous CV event, a new diagnosis of diabetes and were using a statin or aspirin.
There was no difference in cancer-specific outcomes, including lung, breast, prostate and colon cancers and melanoma, among the groups. Additionally, according to Bordeleau, adjusted models for key clinical subgroups remained neutral (P>0.17), and the risk for new and recurrent cancers was similar between groups.
Further, HbA1c level and glucose lowering therapies, as well as BMI, had no effect on the risk for cancer; this included metformin duration and dose.
The international, randomized ORIGIN trial compared insulin glargine (Lantus, Sanofi-Aventis) with standard care and omega-3 fatty acids or placebo in patients with diabetes or prediabetes at high risk for cardiovascular events. – by Stacey L. Adams
For more information:
Bordeleau L. #385-OR. Presented at: ADA Scientific Sessions; June 21-25, 2013; Chicago.
Disclosure: The study was supported by Sanofi.