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Sanofi Aventis: New Real Life Studies Illustrate Greater A1C Lowering and Cost Benefit Observed With LANTUS(R) Over Detemir and NPH Insulin

Paris (ots/PRNewswire)

  • The THIN, ROLE and LIVE-DE Studies Used Medical Databases or Medical Records to Compare the Benefits of Different Insulin Treatments in Thousands of People Living With Type 2 Diabetes
  • Abstracts 1000, 1001 and 1004
Sanofi-aventis, a world leader in diabetes care, announced the
results of three non-interventional studies presented at the 44th
annual meeting of the European Association for the Study of Diabetes
(EASD) in Rome, Italy (September 7 - 11, 2008), which demonstrated
that treatment with LANTUS(R) (insulin glargine (rDNA origin)
injection):
- showed greater A1C lowering than detemir and provided cost
      savings (THIN Study)
    - showed greater A1C lowering, resulted in a lower rate of
      hypoglycemia, and reduced total healthcare cost compared to NPH (ROLE
      Study)
    - resulted in better patient satisfaction than NPH (LIVE-DE
      Study)
As a reflection of everyday clinical practice, studies like THIN,
ROLE and LIVE-DE provide important comparative data on different
treatment approaches in a real life setting.
"In recent years, as the number of people in the world living
with diabetes has grown to epidemic proportions, the subsequent costs
of diabetes care have also risen steadily," stated Alexandre Moreau,
Vice President, Diabetes-Metabolism Franchise. "In addition to its
continued investment in traditional clinical studies, sanofi-aventis
is also committed to demonstrate LANTUS(R) benefits in real
practice."
About the Study Results
All three studies assessed cost-effectiveness within U.S. and
European healthcare systems, with two studies (ROLE, LIVE) comparing
outcomes of LANTUS(R) with NPH, and one study (THIN) comparing
treatment with LANTUS(R) to treatment with detemir. Following are key
findings from the studies:
Health outcomes and treatment satisfaction in patients using
LANTUS(R) versus NPH therapy:
- ROLE: Adjusted one-year average A1C was 8.05% for LANTUS(R)
      versus 8.51% for NPH (Delta= -0.45, p=0.0036). Two-year average A1C
      was 8.03% for LANTUS(R) versus 8.37% for NPH (Delta= -0.33, p=0.0099).
    - LIVE-DE: Patients taking LANTUS(R) reported significantly
      better physical well-being and higher treatment satisfaction compared
      to NPH insulin (via SF-12, DTSQs and insulin treatment experience
      questionnaire). Glucagon use for treatment of severe hypoglycemic
      events was documented in 4 NPH insulin patients. There was no
      documented glucagon use for severe hypoglycemic events in patients
      treated with LANTUS(R).
    Healthcare costs in patients using LANTUS(R) therapy:
    - THIN: For LANTUS(R) and detemir, discounted cost per patient
      was GBP6,536 and GBP6,556 respectively; quality adjusted life years
      were 7.71 and 7.64 for LANTUS(R) and detemir respectively. This
      resulted in a dominant (more effective and marginally cost saving)
      discounted incremental cost effectiveness ratio in favour of LANTUS(R).
    - ROLE: Adjusted one-year total healthcare costs for patients
      who began treatment with LANTUS(R) were $16,184, versus $21,104
      (quarterly difference= -$1,034, p=0.0372) for those who began treatment
      with NPH. Two-year costs for the respective treatment groups were
      $30,032 versus $42,208 (quarterly difference= -$1,522, p=0.0029).
    - LIVE-DE: Mean total costs for direct diabetes care were
      slightly lower in LANTUS(R) patients than in NPH insulin patients (658
      EUR versus 685 EUR per patient during 6 months, p=0.001 by Wilcoxon
      sum rank test). Despite higher drug costs for LANTUS(R), relevant
      savings were observed in utilization of short-acting insulins (-62
      EUR), test strips (-52 EUR), and needles (-6 EUR). LANTUS(R) patients
      also had on average fewer basal insulin injections per day (1.09 versus
      1.47) and required fewer blood glucose self-measurements. After
      adjustment for relevant variables, total cost per patient for the 6
      month treatment duration with LANTUS(R) was marginally higher than with
      NPH (adjusted average: +73 EUR, p<0.001, ANCOVA).
    Glycemic control between patients using Lantus(R) versus detemir therapy:
    - THIN: Compared with detemir over a 12-month period, greater
      A1C lowering was observed in patients taking LANTUS(R)
      (difference=0.29%, p=0.021) in A1C. Mean insulin doses in units per kg
      per day were 0.53 for LANTUS(R) and 0.56 for detemir. The superior
      efficacy results shown with LANTUS(R) versus detemir in real life
      setting are consistent with the findings from a recently published
      randomized clinical trial; in this comparative study, more than half
      of detemir patients required two injections per day and a much higher
      dose of detemir was needed to achieve the same A1C reductions observed
      in patients taking one injection per day of LANTUS(R).(i)
    About the Study Designs
    - THIN: the analysis was derived from the THIN UK primary care
      database. 2554 insulin naïve type 2 diabetes patients (LANTUS(R) group:
      2197; detemir group: 357) that initiated either LANTUS(R) or detemir
      were included. The baseline HbA1c was respectively 9.5 and 9.7% in the
      LANTUS(R) and in the detemir group. Efficacy was measured 12 months
      after insulin introduction
    - ROLE: the analysis was derived from a US managed care
      database 2839 insulin naïve type 2 diabetes patients (LANTUS(R) group:
      2105; NPH group: 734) that initiated either LANTUS(R) or NPH were
      included. The baseline A1C was respectively 9.3 and 8.9% in the
      LANTUS(R) and in the NPH group. Efficacy was measured 12 and 24 months
      after insulin introduction
    - LIVE-DE: it was a non-interventional, cross-sectional,
      retrospective study performed in 199 randomly selected centers of
      primary care physicians in Germany. The study enrolled 1602 consecutive
      type 2 diabetes patients with statutory health insurance status who
      were eligible for documentation when either treated with insulin
      LANTUS(R) or NPH insulin based regimens for at least 6 months prior of
      documentation.
Additional details about the THIN, ROLE and LIVE-DE data are
included in the study abstracts, available at EASD.org.
About LANTUS(R) (insulin glargine (rDNA origin))
LANTUS(R) is indicated for once-daily subcutaneous administration
in the treatment of adult patients with type 2 diabetes mellitus who
require basal (long-acting) insulin for the control of hyperglycemia
and for adult and pediatric patients (6 years and older) with type 1
diabetes mellitus. LANTUS(R) demonstrates a peakless and sustained
concentration/time profile over 24 hours thus reducing the risk of
hypoglycemia and allowing a constant and high efficacy over 24h with
one single daily injection. LANTUS(R) is the number one prescribed
insulin worldwide.
About APIDRA(R) (insulin glulisine (rDNA origin))
APIDRA(R) is a rapid-acting insulin analog with a unique
zinc-free molecular structure that maintains a rapid onset and a
short duration of action, indicated for adults and for adolescents
and children (6 years and older) with diabetes in the EU. APIDRA(R)
offers patients mealtime dosing flexibility-it can be taken shortly
(0-15 min) before or soon after the meal. APIDRA(R) is also flexible
for use in a wide range of patients from lean to obese. APIDRA(R) is
the logical partner to LANTUS(R) once prandial insulin is required.
About Diabetes
Diabetes is a chronic, progressive widespread disease in which
the body reduces or does not produce or properly use insulin - the
hormone needed to convert glucose (sugar) into energy. In 2008 over
250 million people worldwide are living with diabetes. This number
would dramatically increase up to 380 million by 2025. It is
estimated more than 24 million Americans have diabetes. At the same
time, more than 40% of those diagnosed are not achieving the general
blood sugar control standard of A1C <7% recommended by the American
Diabetes Association and the European Association for the Study of
Diabetes (ADA/EASD). The A1C test reflects average blood glucose
levels over a two- to three-month period. Without proper insulin
production and action, glucose remains in the blood, leading to
chronic hyperglycaemia (raised blood sugar). This can result in short
and long-term complications, many of which, if not prevented and left
untreated, can be fatal. All have the potential to reduce the quality
of life of people with diabetes and their families.
The most common long-term complications are:
- Diabetic nephropathy (kidney disease), which may result in
      total kidney failure and in the need for dialysis or kidney transplant.
    - Diabetic eye disease (retinopathy and macular oedema),
      damage to the retina of the eye which can lead to vision loss.
    - Diabetic neuropathy (nerve disease), which can ultimately
      lead to ulceration and amputation of the feet and lower limbs.
    - Cardiovascular disease, which affects the heart and blood
      vessels and may cause fatal complications such as coronary heart
      disease (leading to a heart attack) and stroke.
Diabetes is the fourth leading cause of death by disease
globally. Every year, 3.8 million people die from diabetes-related
causes.
About sanofi-aventis
Sanofi-aventis, a leading global pharmaceutical company,
discovers, develops and distributes therapeutic solutions to improve
the lives of everyone. Sanofi-aventis is listed in Paris (EURONEXT:
SAN) and in New York (NYSE: SNY).
Forward Looking Statements
This press release contains forward-looking statements as defined
in the Private Securities Litigation Reform Act of 1995, as amended.
Forward-looking statements are statements that are not historical
facts. These statements include product development, product
potential projections and estimates and their underlying assumptions,
statements regarding plans, objectives, intentions and expectations
with respect to future events, operations, products and services, and
statements regarding future performance. Forward-looking statements
are generally identified by the words "expects," "anticipates,"
"believes," "intends," "estimates," "plans" and similar expressions.
Although sanofi-aventis' management believes that the expectations
reflected in such forward-looking statements are reasonable,
investors are cautioned that forward-looking information and
statements are subject to various risks and uncertainties, many of
which are difficult to predict and generally beyond the control of
sanofi-aventis, that could cause actual results and developments to
differ materially from those expressed in, or implied or projected
by, the forward-looking information and statements. These risks and
uncertainties include among other things, the uncertainties inherent
in research and development, future clinical data and analysis,
including post marketing, decisions by regulatory authorities, such
as the FDA or the EMEA, regarding whether and when to approve any
drug, device or biological application that may be filed for any such
product candidates as well as their decisions regarding labeling and
other matters that could affect the availability or commercial
potential of such products candidates, the absence of guarantee that
the products candidates if approved will be commercially successful,
the future approval and commercial success of therapeutic
alternatives as well as those discussed or identified in the public
filings with the SEC and the AMF made by sanofi-aventis, including
those listed under "Risk Factors" and "Cautionary Statement Regarding
Forward-Looking Statements" in sanofi-aventis' annual report on Form
20-F for the year ended December 31, 2007. Other than as required by
applicable law, sanofi-aventis does not undertake any obligation to
update or revise any forward-looking information or statements.
(i) Rosenstock J et al. A randomised, 52-week, treat-to-target
trial comparing insulin detemir with insulin glargine when
administered as add-on to glucose-lowering drugs in insulin-naive
people with type 2 diabetes. Diabetologia. 2008 March; 51(3):
408-416.

Contact:

Global Media Contact: Anna Radjanova, MD, Tel: +33-6-07-28-61-63,
E-mail: anna.radjanova@sanofi-aventis.com

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