Authors: V Mohan, Anil Bhansali, Prasanna Kumar, Aravind Patil, Praveen Raj

Date: March, 2023

Link: Click here to Access the PDF

Introduction-

The prevalence of type 2 diabetes (T2D) is increasing at exponential rates, the estimated prevalence of diabetes in adults aged 20–79 years has more than tripled, from an estimated 151 million (4.6% of the global population at the time) to 537 million (10.5%). 643 million people will have diabetes by 2030. If trends continue, the number will jump to a staggering 783 million (12.2%) by 2045. Almost 90% of people with undiagnosed diabetes live in low- and middle-income countries. India accounts for 1 in 7 of all adults living with diabetes worldwide. Asian Indians have a higher predilection for T2DM, and this is due to the ‘Asian-Indian phenotype. Dietary carbohydrates form the major source of energy in Asian diets. There have also been rapid changes in the dietary composition of Asian Indians such that diets today are high in refined carbohydrates, sugars, fats, and salt. All these factors contribute to the rising prevalence of diabetes, hypertension, and cardiovascular diseases (CVDs). The carbohydrate quantity and quality play a vital function in the management of diabetes. High glycaemic index foods elicit higher glycaemic and insulinemic responses and promote insulin resistance and type 2 diabetes (T2D) through beta-cell exhaustion. The higher the plasma glucose level with which a patient goes to bed as a result of postprandial hyperglycemia, the higher will be the fasting hyperglycemia in the morning. Similarly, the higher the fasting hyperglycemia in the morning, the higher the postprandial level during the day.

Authors: Grit Andersen MD, Gursharan Singh PhD, Sundara Moorthi Nainar Murugesan PhD, Rajesh Gogineni MPharm, Nirant Sharma MSc, Jayanti Panda MPharm, Ashwani Marwah MSc, Subramanian Loganathan MD, Sandeep N. Athalye MD

Date: Jan 23rd, 2023

Link: https://doi.org/10.1111/dom.14994

Abstract –

Aim: To establish the pharmacokinetic (PK) and pharmacodynamic (PD) equivalence of proposed biosimilar Insulin N (Biocon’s Insulin-N; Biocon Biologics Ltd., Bangalore, India) and US-licensed Humulin® N (Humulin-N; Eli Lilly and Company, Indianapolis, IN, USA) in healthy subjects.

Materials and methods: This was a phase-1, single-centre, double-blind, randomized, three-period, six-sequence, partially replicated, crossover, 24-h euglycaemic clamp study. Overall, 90 healthy subjects were randomized, of whom 85 completed the study. The subjects received either two single doses of Biocon’s Insulin-N and a single dose of Humulin-N or two single doses of Humulin-N and a single dose of Biocon’s Insulin-N subcutaneously at a dose of 0.4 IU/kg. The primary PK endpoints were the area under the insulin concentration-time curve from 0 to 24 h (AUCins.0-24h) and the maximum insulin concentration (Cins.max). The primary PD endpoints were the area under the glucose infusion rate (GIR) curve from 0 to 24 h (AUCGIR.0-24h) and the maximum GIR (GIRmax).

Results: Biocon’s Insulin-N was found to be equivalent to Humulin-N for the primary PK (geometric 90% confidence interval for the least squares mean ratio: AUCins.0-24h, 100.98%-115.66% and Cins.max, 95.91%-110.16%) and PD endpoints (intra-subject variability ≥0.294; 95% upper confidence interval [(μT – μR)2 − θσ2WR] <0; point estimates of geometric least squares mean ratio: AUCGIR.0-24h, 104.61% and GIRmax, 100.81%). The safety profile of Biocon’s Insulin-N was similar to that of Humulin-N, and no serious adverse events were reported.

Conclusion: PK and PD equivalence was shown between Biocon’s Insulin-N and Humulin-N in healthy subjects, and both treatments were well tolerated and considered safe.

Conflict of interest statement: GA is an employee of Profil, Neuss, Germany. GS, AM, JP, SL and SNA are employees of Biocon Biologics Ltd and hold stocks in Biocon. NS is an employee of Biocon Biologics Ltd. SMNM is no longer employed by Biocon Biologics Ltd.

Authors: Leona Plum-Mörschel, Oliver Klein, Gursharan Singh, Sundara Moorthi Nainar Murugesan, Ashwani Marwah, Nirant Sharma, Jayanti Panda, Subramanian Loganathan, Gopu Chandrasekharan Lakshmi, Sandeep N Athalye

Date: Sep 24th, 2022

Link: https://pubmed.ncbi.nlm.nih.gov/35589611/

Abstract –

Aim: To establish the pharmacokinetic (PK) and pharmacodynamic (PD) equivalence of proposed biosimilar insulin 70/30 (Biocon’s Insulin-70/30) and HUMULIN® 70/30 (HUMULIN-70/30; Eli Lilly and Company, IN).

Materials and methods: In this phase 1, automated euglycaemic glucose clamp study, 78 healthy subjects were randomized (1:1) to receive a single dose of 0.4 IU/kg of Biocon’s Insulin-70/30 and HUMULIN-70/30. Plasma insulin concentrations and glucose infusion rates (GIRs) were assessed over 24 hours. Primary PK endpoints were area under the insulin concentration-time curve from 0 to 24 hours – AUC_ins.0-24h – and maximum insulin concentration – C_ins.max . Primary PD endpoints were area under the GIR time curve from 0 to 24 hours – AUC_GIR.0-24h – and maximum GIR – GIR_max .

Results: Equivalence was shown between Biocon’s Insulin-70/30 and HUMULIN-70/30 for the primary PK/PD endpoints. The 90% confidence intervals of the treatment ratios were entirely within the acceptance range of 80.00%-125.00%. The secondary PK/PD profiles were also comparable. There were no clinically relevant differences in the safety profiles of the two treatments and no serious adverse events were reported.

Conclusion: PK/PD equivalence was demonstrated between Biocon’s Insulin-70/30 and HUMULIN-70/30 in healthy subjects. Treatment with Biocon’s Insulin-70/30 and HUMULIN-70/30 was well tolerated.

Conflict of interest statement: LPM has received speaker honoraria and travel grants from Eli Lilly, Gan & Lee Pharmaceuticals and Novo Nordisk. GS, AM, JP, SL and SNA are employees of Biocon Biologics Ltd and hold stocks in Biocon. SMNM and GCL are employees of Biocon Biologics Ltd. NS was employed with Biocon Biologics Ltd at the time of study conduct and preparation of the manuscript but is no longer employed by Biocon Biologics Ltd. OK is an employee of Profil, Neuss, Germany and has nothing to disclose.

Authors: Leona Plum-Mörschel MD, PhD, Gursharan Singh MBBS, PhD, Sundara Moorthi Nainar Murugesan MPharm, PhD, Ashwani Marwah MSc, Jayanti Panda MPharm, Subramanian Loganathan MD, Sandeep N. Athalye MD

Date: Jan 3rd, 2022

Link: https://doi.org/10.1111/dom.14635

Abstract –

Aim: To establish equivalence in the pharmacokinetic (PK) and pharmacodynamic (PD) endpoints between proposed biosimilar Insulin-R (Biocon’s Insulin-R) and Humulin® R using the euglycaemic clamp technique in healthy subjects.

Materials and methods: In this phase-1 automated euglycaemic glucose clamp study, 42 healthy subjects were randomized (1:1) to receive a single dose of 0.3 IU/kg of Biocon’s Insulin-R and Humulin-R. Plasma insulin concentrations and glucose infusion rates (GIRs) were assessed over 12 hours. Primary PK endpoints were area under the insulin concentration-time curve from 0 to 12 hours (AUCins.0-12h) and maximum insulin concentration (Cins.max). Primary PD endpoints were area under the GIR time curve from 0 to 12 hours (AUCGIR.0-12h) and maximum GIR (GIRmax).

Results: Equivalence was demonstrated between Biocon’s Insulin-R and Humulin-R for the primary PK and PD endpoints. The 90% confidence intervals were within 80.00% to 125.00% limits. The PK and PD profiles were comparable. There were no significant differences in the safety profiles of the two treatments, and no serious adverse events were reported.

Conclusion: PK and PD equivalence was demonstrated between Biocon’s Insulin-R and Humulin-R in healthy subjects. Treatment with Biocon’s Insulin-R and Humulin-R was well tolerated.

Conflict of interest statement: GS, SMNM, AM, JP, SL, and SNA are employees of Biocon Biologics Ltd. LP-M has received speaker honoraria and travel grants from Eli Lilly and Company and Novo Nordisk. GS, AM, JP, SL, and SNA hold stocks in Biocon.