<a href="${link:{uuid:{3c621072-b317-4715-bb3e-c63ceb933735},repository:{dam},path:{/Portal/UK/Prescribing-Information/Dupixent-AD-and-PN-UK-PI.pdf}}}">DUPIXENT® (dupilumab) Prescribing&nbsp;Information UK</a>
<h3>Introduction</h3>
Skin diseases are the fourth most common cause of nonfatal morbidity, impacting nearly one-third of the global population. Chronic diseases cause substantial burden, and despite their high prevalence, this burden is often underestimated.1,2
Chronic skin diseases including atopic dermatitis (AD), notably affect patients' health-related quality of life (HRQoL), including physical health, emotional well-being, and social interactions. Patients with inflammatory skin diseases often suffer from symptoms that contribute to psychological distress, including anxiety and depression, ultimately resulting in cumulative long-term impairment.3 Understanding CLCI is essential to fully grasp the enduring burden of chronic skin diseases and the irreversible impact on patients' lives over time.4
<h3>CLCI in Dermatology: What You Need to Know?</h3>
CLCI is a theoretical concept that describes the non-reversible burden of chronic skin diseases over time. In some cases, this persistent burden can lead to chronic impairment and missed opportunities resulting in lasting psychosocial and personal damage. Some individuals are less vulnerable to CLCI, while others are more affected by factors such as stigma, physical comorbidities, and psychological comorbidities. Difficulty in coping with these factors increases the patients' risk of vulnerability.4

Hypothetical impairment over a patient’s life&nbsp;course4 
 Adapted from Augustin A et al. 2013.4
Recognising these factors is crucial for healthcare professionals to develop comprehensive management strategies aimed at mitigating the long-term effects of chronic skin diseases such as AD.
<h3>The Chronic Nature of AD: A&nbsp;Multidimensional Burden</h3>
AD is a chronic, relapsing condition marked by eczematous lesions and severe pruritus. Although AD often manifests in infancy, affecting approximately 20% of children, it remains highly prevalent in adults, indicating a lifelong disposition.5
The chronic nature of AD can lead to a continuous cycle of flare-ups and remissions. The atopic comorbidities such as food allergies, asthma, allergic rhinitis, other immune-mediated inflammatory diseases, and non-atopic comorbidities such as mental health disorders, may develop in patients with severe disease.4–6

The burden of uncontrolled AD may further lead to other factors such as sleep loss, impaired functioning, self-esteem issues, reduced productivity, cardiovascular diseases, poor bone health, financial strain, and loss of opportunities.23–27
<h3>Listen to Dr Antonia Lloyd-Lavery discuss the comorbidities associated with AD</h3>

Read to learn more about the concept of CLCI, how it manifests in atopic dermatitis and its impact on patients.

SPECIALTY-CARE

DUPIXENT

ATOPIC-DERMATITIS

RESPIRATORY

The Hidden Impact of Cumulative Life Course Impairment (CLCI) in Dermatology: An Overview

<h3>High Disease Burden in Low BSA Involvement</h3>
This chronic and relapsing nature of AD underscores the importance of evaluating the disease's impact, even when the Body Surface Area (BSA) involvement is minimal.
Patients with a low BSA involvement may experience a high disease burden.28 The severity of symptoms and their impact on QoL are not solely dependent on the extent of skin involvement but also on the functionality and visibility of the affected areas.28,29 
 Hands and feet and face are commonly reported to be affected by AD. These areas can lead to significant physical impairments that affect the QoL, causing psychological distress and disrupting work and school productivity.29–34
Over time, these ongoing challenges can contribute to CLCI, highlighting the long-term, cumulative burden of chronic skin diseases.3 Timely intervention and escalation of therapy for patients with uncontrolled moderate to severe AD can be critical in helping to manage the signs, symptoms and quality of life impacts of uncontrolled AD.35

The graph is a hypothetical model of CLCI throughout the course of AD, adapted from Kimball, et al. J Eur Acad Dermatol Venereol. 201027 and Bieber T, et al. Nat Rev Drug Discov. 2023.36

<h3>Conclusion</h3>
CLCI is a crucial concept in understanding the long-term impact of chronic skin conditions like AD.3,4 For patients with moderate-to-severe AD, the burden extends beyond the skin, causing psychological and social distress, and affecting the overall QoL.29–31
Timely and appropriate escalation for patients suffering with uncontrolled AD may help reduce the burdens they face.35
<h3>Watch Prof Michael Cork discuss disease modification in AD</h3>

<h6>DUPIXENT is approved for use in eligible patients as young as 6 months old in AD.37</h6>

DUPIXENT is indicated for use in patients aged 12 years and older with moderate-to-severe atopic dermatitis (AD), and in patients aged 6 months to 11 years of age with severe AD, who are candidates for systemic therapy.37

References
<ol>
 <li>Seth D et al. Curr Dermatol Rep. 2017; 6(3): 204–210.</li>
 <li>Flohr C et al. Br J Dermatol. 2021;184: 189–190.</li>
 <li>von Stülpnagel CC et al. J Eur Acad Dermatol Venereol. 2021; 35(11):2166–2184.</li>
 <li>Augustin A et al. Wound Medicine. 2013; 1: 2–6.</li>
 <li>Weidinger S et al. Lancet. 2016; 387(10023): 1109–1122.</li>
 <li>Simpson EL et al. J Am Acad Dermatol.&nbsp;2016; 74(3): 491–498.</li>
 <li>Wang V et al. Ann Allergy Asthma Immunol. 2021;126(1): 3–12.</li>
 <li>Cameron S et al. Allergy. 2024; 79(1):26–36.</li>
 <li>Weidinger S et al.&nbsp;Br J Dermatol. 2024; 190(6): 846–857.</li>
 <li>Calzavara-Pinton P et al. Adv Ther. 2023; 40(12): 5366–5382.</li>
 <li>Lee SW et al.&nbsp;Allergy Asthma Immunol Res. 2023;15(2): 231–245.</li>
 <li>Lundin S et al. J Eur Acad Dermatol Venereol. 2023; 37(9): 1854–1862.</li>
 <li>Wan J et al.&nbsp;J Allergy Clin Immunol Pract. 2023; 11(10):3123–3132.e3.</li>
 <li>Silverberg JI et al.&nbsp;JAMA Dermatol. 2015; 151(4): 401–409.</li>
 <li>Wu D et al.&nbsp;Ann Transl Med. 2021; 9(1): 40.</li>
 <li>Silverberg JI et al. J Invest Dermatol. 2015; 135: 56–66.</li>
 <li>Chang YS et al. J Allergy Clin Immunol. 2018; 142(4): 1033–1040.</li>
 <li>Paller AS et al. J Am Acad Dermatol. 2022; 87(5): 1104–1108.</li>
 <li>Paller AS et al. Dermatol Ther (Heidelb). 2023; 13(4): 961–980.</li>
 <li>Neri I et al.&nbsp;J Asthma Allergy. 2023; 16: 383–396.</li>
 <li>Girolomoni G et al.&nbsp;Dermatol Ther (Heidelb). 2021; 11(1): 117–130.</li>
 <li>Ibler K et al. Dermatol Reports. 2011; 3(1): e5.</li>
 <li>Bacci ED et al.&nbsp;J Dermatolog Treat. 2023; 34(1): 2202288.</li>
 <li>Fasseeh AN et al. Dermatol Ther (Heidelb). 2022; 12(12): 2653–2668.</li>
 <li>Davis DMR et al. J Am Acad Dermatol. 2022; 86(6): 1335–1336.e18.</li>
 <li>Thyssen JP et al. J Allergy Clin Immunol. 2023; 151(5): 1155–1162.</li>
 <li>Kimball AB et al. J Eur Acad Dermatol Venereol. 2010; 24(9):989–1004.</li>
 <li>Silverberg JI et al.&nbsp;Dermatitis. 2023; 34(2): 135–144.</li>
 <li>Simpson EL et al.&nbsp;J Am Acad Dermatol. 2024; 90(6): 1190–1199.</li>
 <li>Grant L et al.&nbsp;Adv Ther. 2020; 37(2): 692–706.</li>
 <li>Silverberg JI et al. J Am Acad Dermatol. 2023; 89(3): 519–528.</li>
 <li>Jaros J et al.&nbsp;Dermatitis. 2020; 31(3): 169–177.</li>
 <li>Rønnstad ATM et al. J Am Acad Dermatol.&nbsp;2024; 90: 616–618.</li>
 <li>Moore RA&nbsp;et al. Rule of Nines. Available&nbsp;at:&nbsp;<a href="https://www.ncbi.nlm.nih.gov/books/NBK513287/" target="_blank">https://www.ncbi.nlm.nih.gov/books/NBK513287/</a>. Date last accessed: December 2025.</li>
 <li>Davis DMR et al.&nbsp;J Am Acad Dermatol. 2024; 90(2): e43-e56.</li>
 <li>Bieber T. Nat Rev Drug Discov. 2023;22(8):662-680.</li>
 <li>DUPIXENT Summary of Product Characteristics. 2025.&nbsp;</li>
</ol>

Read to learn more about the concept of CLCI, how it manifests in atopic dermatitis and its impact on patients.

DUPIXENT® (dupilumab) Prescribing Information UK

<h2>RSV poses a risk for all infants2,3</h2>
Respiratory syncytial virus (RSV) is a common virus causing respiratory tract infections. While usually mild and self-limiting, RSV affects approximately 329,425 children under 5 years old each year in the UK, primarily between October and March. In infants, who are at an increased risk of LRTI, it carries a significant disease burden, with babies 0–12 months old incurring 49% of the total annual cost of RSV in children under 5 years in the UK, in addition to the emotional and practical burden on families and carers.2-4

<h3>All infants need protection from RSV infection.5,6 RSV infection is:</h3>

Two out of three infants will be infected with RSV by the age of 17

Common

Leading cause of infant hospitalisations and LRTI5 Infants are 14× more likely to be hospitalised due to RSV than the common flu8

Serious

Among infants hospitalised for RSV: ~50% were born out of RSV season9 &gt;70% were born at term and healthy6,10

Unpredictable

Watch Dr Simon Nadel discuss the risk of RSV to all infants

<h3>Understanding the protection gaps in the UK</h3>
Regardless of gestational age, all preterm infants are at higher risk of RSV complications, including hospitalisation.11
A maternal immunisation programme was launched in 2024 in the UK, and from September 2025, the programme includes Beyfortus (nirsevimab) for very and extremely premature infants (born &lt;32 wGA).2
In theory, this updated programme should offer comprehensive protection for all babies. But in practice, it may leave a substantial number of preterm infants (born between 32 and 36 wGA) unprotected for their first winter respiratory season.12
Besides this, thousands of healthy and at term infants remain vulnerable as they enter their first RSV season due to significant protection gaps in the current childhood RSV immunisation programme. Not all eligible mothers receive vaccination, the latest published report in April 2025 showed an uptake of 54%.13 In addition, for those who do receive the vaccine, there will continue to be babies who are unable to benefit:2,14,-16
<ul>
 <li>infants born too soon after maternal immunisation</li>
 <li>infants born more than 6 months before RSV season</li>
 <li>infants whose maternal antibodies will wane during the season</li>
</ul>

Dr Simon Nadel discusses RSV in unprotected infants

<h3>Impact on infants</h3>

Data from 21 NHS trusts during the 2024–2025 RSV season in England demonstrates that hospitalisation associated with RSV is still a burden on infants. Of the 2,149 RSV hospital admissions in children under 5 (excluding ICU and HDU admissions), 58.8% were infants aged under 1, with 879 aged 6 months and younger. In addition, a further 164 infants (&lt;1 year) were admitted to intensive care and high dependency units, with 80% being below 6 months of age.17

<h3>RSV is a threat to all infants, yet many remain vulnerable without protection this season12,13,16</h3>

Abbreviations and footnotes

References

Prescribing Information UK

VACCINES

BEYFORTUS

RESPIRATORY-SYNCYTIAL-VIRUS

Beyfortus▼ (Nirsevimab): Help protect the unprotected

<h2 style="text-align:center;">A Century of Insulin Experience</h2>

For over 100 years, Sanofi has been committed to the development and production of insulin therapies for people living with diabetes1. Our long-standing heritage in diabetes care has enabled us to build extensive expertise in insulin manufacturing and supply chain management.

<h3 style="text-align:center;">Our Commitment to Supply Sustainability</h3>
Sanofi recognises the critical importance of maintaining a reliable insulin supply for patients who depend on our treatments. We maintain robust contingency plans and strategic inventory management to help ensure continuity of supply across our insulin portfolio.

<h3 style="text-align:center;">Investment in Manufacturing Capabilities</h3>
We continue to invest in our global manufacturing network to enhance production capacity and implement technological advancements. Our manufacturing facilities operate to rigorous quality standards, with regular monitoring and evaluation to maintain compliance with international regulatory requirements.

<h2 style="text-align:center;">Evaluating the Environmental Impact Across the Pen Manufacturing Chain</h2>
Toujeo®(insulin glargine U300) pens have been developed with a strong focus on environmental sustainability, supported by a rigorous ISO-certiﬁed Life Cycle Assessment (LCA) conducted in 2024.1 This assessment evaluated the environmental footprint of the product across its entire lifecycle—from raw material sourcing to manufacturing, distribution, use, and disposal. The eco-design approach has led to the below environmental gains, by optimising each step of Toujeo's product lifecycle:1

A key milestone in this journey is the transition to 100% renewable electricity across all insulin manufacturing facilities, reinforcing our commitment to sustainable healthcare delivery.1
1.&nbsp;&nbsp;Toujeo® Environmental Claims. MAT-GLB-2502484. Based on an ISO-compliant Life Cycle Assessment (LCA) conducted in 2024 on Sanoﬁ's insulin portfolio. July 2025. &nbsp;

<h2 style="text-align:center;">RePen Recycling Scheme</h2>
Sanofi is committed to reducing the environmental impact of diabetes care. The RePen recycling scheme allows patients to return used insulin pens for responsible disposal and recycling.
For more information about the RePen recycling programme and to find your nearest participating location, please visit <a href="https://www.mysanofiinsulin.co.uk/repen/">mysanofiinsulin.co.uk/repen</a>

<h2>Dedicated Support</h2>
Our UK-based customer care team is available to provide support and information regarding our insulin products via <a href="mailto:sanoficares@sanofi.com" target="_blank">sanoficares@sanofi.com</a>.
Our team can provide information on product availability, storage recommendations, and address general enquiries about our insulin products.

OTHER-DIABETES-TOPICS

TYPE-2-DIABETES

TYPE-1-DIABETES

Toujeo®

Lantus®

MAT-XU-2504557 (v1.0) | Date of preparation: December 2025&nbsp;

Supporting you with reliable and sustainable insulin supply

Sanofi's Commitment to Diabetes

<h2 style="text-align:center;">Starting patients on toujeo (insulin glargine U/300mL)¹</h2>
Toujeo is a basal insulin for once daily administration at any time of the day, preferably at the same time every day. When needed, patients can administer Toujeo up to 3 hours before or after their usual time of administration. The dose regimen (dose and timing) should be adjusted according to individual response.1 Toujeo is indicated for the treatment of diabetes mellitus in adults, adolescents and children from the age of 6 years.1

Toujeo is to be used once daily with meal time insulin and requires individual dose adjustments. Toujeo must be combined with short-/rapid acting insulin to cover mealtime insulin requirements.

Patients with type 1 diabetes mellitus¹

The recommended daily starting dose is 0.2 units/kg followed by individual dose adjustments. Toujeo can also be given together with other anti hyperglycaemic medicinal products.

Patients with type 2 diabetes mellitus¹

Click here for a checklist on starting patients on Toujeo

<h2 style="text-align:center;">Switching from different basal insulins to toujeo1</h2>
<h3>Close metabolic monitoring is recommended during the switch and in the initial weeks thereafter, with potential dose adjustments and adjustments required to the patients’ treatment regime. 
 From insulin glargine U1001</h3>
<ul>
 <li>Insulin (glargine 100 units/mL) and Toujeo are not bioequivalent and are not directly interchangeable</li>
 <li>Initial switch: unit-to-unit basis</li>
 <li>Dose adjustment: May require a 10-18% higher dose</li>
</ul>
Example: Lantus (insulin glargine 100 units/mL) 40 units once daily = 40 units Toujeo (may need up to 47 units)
<h3>From once-daily insulins1</h3>
<ul>
 <li>On a unit to unit based on the previous basal insulin dose</li>
</ul>
<h3>From twice-daily insulins1</h3>
<ul>
 <li>80% of total daily dose as Toujeo</li>
 <li>Example: 20 units morning + 15 units evening determir = 28 units Toujeo (80% of 35)</li>
</ul>

<h2>Practical Implementation2</h2>

<ul>
 <li>Check the DHSC Medicines Supply Notiﬁcation and availability via the SPS Medicines Supply Tool. &nbsp;</li>
 <li>People with allergies to alternative insulins should be referred to local allergy or diabetes services as required.</li>
 <li>Evaluate co-morbidities, and prioritise those in high-risk groups, such as those below: 
 <ul>
 <li>Impaired hypoglycaemia awareness</li>
 <li>High glucose variability on CGM, history of severe hypoglycaemia or recurrent diabetic ketoacidosis (DKA)</li>
 <li>Evidence of lipohypertrophy at injection sites</li>
 <li>Frailty and/or older age</li>
 <li>Children and adolescents</li>
 <li>Renal or severe hepatic impairment</li>
 <li>Cognitive or functional impairment</li>
 <li>Learning diﬃculties or low health literacy</li>
 <li>Visual impairment and manual dexterity problems</li>
 <li>High alcohol intake or binge drinking</li>
 <li>High level of physical activity</li>
 </ul></li>
</ul>

Pre-switch²

<ul>
 <li>As part of the clinical review, assess whether the current insulin regimen in type 2 diabetes could be optimised by introducing / switching to diﬀerent insulin types (e.g., rapid-acting, or mixed insulin) or by incorporating non-insulin therapies.</li>
 <li>When switching between insulins, there can be diﬀerences between absorption, potency, and action proﬁle, therefore consider reducing doses by 10-20% to avoid the initial risk of hypoglycaemia.</li>
 <li>If lipohypertrophy is detected, considerable dose adjustment is often required when changing injection sites, seek advice and guidance as necessary if unsure.</li>
 <li>When prescribing new insulins, ensure any change in device type is explained to the patient with written product information provided. Patient resources and demonstration devices can be requested via sanoﬁcares@sanoﬁ.com or printed from mysanoﬁinsulin.co.uk</li>
 <li>For those with very erratic glucose levels, or disproportionately high insulin doses, assess injection technique and check for evidence of lipohypertrophy at injection sites.</li>
 <li>Education and support should be provided to help individuals self-adjust doses post-switch, where appropriate, along with a check of understanding of sick day rules.</li>
 <li>Ensure adequate safety netting, advising patients to report any concerns about glucose levels after following provided dose adjustment guidance.&nbsp;</li>
</ul>

During the review²

<ul>
 <li>Risk of glucose instability is elevated during insulin changes. A clinical review with CBG/CGM data is helpful.</li>
 <li>Monitoring should rely on capillary blood glucose (CBG) at least four times daily, CGM, and ketone monitoring (where appropriate)—not HbA1c alone.</li>
 <li>People living with diabetes should be reviewed at 2-3 weeks to support with dose titration, as necessary. For those at higher risk of dysglycaemia aim for close clinical review within 1-2 weeks of change where possible.</li>
 <li>If there is uncertainty seek advice and guidance or refer to community / specialist diabetes services as per locally agreed pathways.&nbsp;</li>
</ul>

Post-switch²

<h5>References</h5>
<ol>
 <li>
 Sanofi. Toujeo 300 units/mL solution for injection in a pre-filled pen - Summary of Product Characteristics (SmPC) 2024.</li>
 <li>
 Association of British Clinical Diabetologists, Primary Care Diabetes Society. Levemir (insulin detemir) discontinuation: Guidance on switching to alternative basal insulins 2025.</li>
</ol>
&nbsp;
MAT-XU-2504556(v1.0) | Date of Preparation: December 2025&nbsp;

A practical guide for initiating or switching patients to a new insulin

How to start and switch insulin: a HCP guide

<h2 style="text-align:center;">When to start patients on insulin¹</h2>
Oﬀer basal insulin as the initial insulin therapy to adults with type 2 diabetes. &nbsp;Consider combining basal and short acting insulin as the initial insulin therapy for adults with type 2 diabetes, especially if the person's HbA1c is 75 mmol/mol (9.0%) or higher. This should be injected either separately or as a pre-mixed (biphasic) preparation.
<h3>Practical information for starting patients on Toujeo (insulin glargine U/300mL)¹</h3>
NG28 advises providing a structured education programme to adults with type 2 diabetes starting insulin therapy. The programme should include:
<ul>
 <li>Injection technique, including rotating injection sites and avoiding repeated injections at the same point within sites</li>
 <li>Self-monitoring</li>
 <li>Dose titration to target levels</li>
 <li>Dietary advice</li>
 <li>The DVLA’s Assessing ﬁtness to drive: a guide for medical professionals</li>
 <li>Managing hypoglycaemia</li>
 <li>Managing acute changes in plasma glucose control</li>
 <li>Support from a healthcare professional trained in insulin therapy.</li>
</ul>
<h3>When initiating insulin for adults with type 2 diabetes:</h3>
<ul>
 <li>Continue to oﬀer metformin to people already taking it</li>
 <li>Stop any other medicines being used solely to manage hyperglycaemia</li>
 <li>Discuss with the person the risks and beneﬁts of continuing medicines for other beneﬁts such as cardiovascular protection or weight management&nbsp;</li>
</ul>
<h3>Choosing an insulin¹</h3>
Make a shared decision with the person on the choice of basal insulin preparation, based on considerations that are speciﬁc to them, including whether:
<ul>
 <li>The person needs help from a carer or healthcare professional to inject insulin or</li>
 <li>There is a particular concern about nocturnal hypoglycaemia or</li>
 <li>The person has a strong preference for once-daily injections.</li>
</ul>
NG28 states that when multiple basal insulin types (including biosimilars) and regimens meet the person’s needs, choose the one with the lowest acquisition cost.&nbsp;

<h5>References</h5>
1. National Institute for Health and Care Excellence. Type 2 diabetes in adults: management. NICE guideline DRAFT [NG28]. 2025.
MAT-XU-2504691(v1.0) | Date of preparation: December 2025&nbsp;

Key indicators and timing for insulin initiation in Type 2 diabetes care pathways

When to Start People with Diabetes on Insulin

<h2>Table of Contents</h2>
<ul>
 <li><a href="#foundation">Foundation of Successful Insulin Transitions</a></li>
 <li><a href="#titration">Titration, Monitoring, and Education</a></li>
 <li><a href="#step-by-step-transition-recommendations">Step-By-Step Transition Recommendations</a>
 <ul>
 <li><a href="#step-1-pre-transition-planning-and-patient-education">Step 1: Pre-transition planning and patient education</a></li>
 <li><a href="#step-2-dosing-and-administration-during-the-transition-period">Step 2: Dosing and administration during the transition period</a></li>
 <li><a href="#step-3-collaborative-transition-monitoring">Step 3: Collaborative transition monitoring</a></li>
 <li><a href="#step-4-continuity-of-care">Step 4: Continuity of care</a></li>
 </ul></li>
 <li><a href="#conclusion">Conclusion</a></li>
 <li><a href="#explore-more">Explore More</a></li>
</ul>

<h2>Foundation of Successful Insulin Transitions</h2>
When diabetes patients need to switch insulin products due to product discontinuations, nurses play an important role in supporting the transition process. This guide provides practical instructions for managing insulin transitions, including titration protocols and patient monitoring strategies.

<h2>Titration, Monitoring, and Education</h2>
Educating patients to ensure hypoglycaemia prevention, especially during the transition phase, is vital for ensuring adherence to any insulin regime.
This includes1:

Blood glucose self-monitoring

Dietary considerations

Injection techniques

Insulin self-titration

Hypoglycaemia management

<h2>Step-By-Step Transition Recommendations</h2>
By following a systematic approach to titration, monitoring, and patient education, nurses may support patients transitioning between insulin products while helping maintain appropriate glycaemic control throughout the process.

<h3>Step 1: Pre-transition planning and patient education</h3>
Before initiating the switch in patients prescribed a different insulin product, nurses should ensure that the patient understands the process and safety considerations. Healthcare systems can reduce medication errors associated with similar-looking insulin products through proper patient counseling. Patients should be encouraged to verify both the insulin product name and dosage during appointments, especially when changes are communicated by phone.2 
 Nurses can foster patient partnership in treatment decisions by providing support during insulin product transitions. Key areas for patient support include3:

Sharing clinical evidence supporting the switch approach.

Clinical Evidence

Providing clear explanations for the transition through educational materials.

Clear Explanations

Offering medical education to support informed, patient-focused decisions.

Medical Education

Ensuring proper dose conversion (unit-to-unit) with consistent monitoring approaches.

Dose Conversion &amp; Monitoring

Respecting patient preferences regarding insulin type and delivery device selection.

Patient Preferences

<h3>Step 2: Dosing and administration during the transition period</h3>
Initial start basal insulin dosing can be calculated using body weight&nbsp; 
 (0.1– 0.2 units/kg per day) while considering the patient's current glucose levels, followed by personalised dose adjustments.1 The approach involves beginning with basal insulin and adjusting doses systematically to reach personalised fasting glucose targets for each patient.1 Patients should always adhere to the specific recommendations and dosing instructions provided by their healthcare provider at the time of prescription.
Toujeo (insulin glargine U300) is a basal insulin for once-daily administration at any time of the day, preferably at the same time every day. When needed, patients can administer Toujeo up to 3 hours before or after their usual time of administration.1 This scheduling flexibility may help during transition periods when patients are adjusting to new treatment routines.

<h3>Step 3: Collaborative transition monitoring</h3>
Switching between basal insulin products requires careful monitoring of <a href="https://pro.campus.sanofi/uk/type-2-diabetes/articles/importance-of-glycaemic-control">blood glucose</a> during the transition period.4 Throughout this monitoring&nbsp;phase, nurses can help recognise indicators of glucose control changes and&nbsp;adjust care approaches accordingly. 
 Patient, family, and HCP education about hypoglycaemia represents another strategy. Additionally, expanding knowledge about glucagon administration for severe hypoglycaemia episodes benefits patients, families, and the broader community.5

Symptom Recognition: Understanding the signs of low blood sugar. Risk Factor Identification: Knowing what can cause hypoglycaemia. Blood Glucose Self-Monitoring Techniques: Enabling timely intervention with food or glucose.

Hypoglycaemia Education: Key Areas5

white

<h3>Step 4: Continuity of care</h3>
Ensuring safe insulin transitions may require a comprehensive approach that integrates improved surveillance with informed, patient-centered decision-making based on individualised benefit-risk&nbsp;assessments.1

<h2>Conclusion</h2>
Successful insulin product transitions require a systematic approach that combines clinical expertise with patient-centric care. You can help&nbsp;facilitate these transitions through titration protocols, consistent patient&nbsp;monitoring, and thorough education throughout the process.

Patient education is an important component of transitions, encompassing not only technical aspects of insulin administration but also enabling patients&nbsp;and their families to recognise and respond appropriately to potential complications, like risk of hypoglycaemia.1,5&nbsp;The approach involving nurses, patients, and the healthcare team may help manage insulin product switches, with a focus on patient needs.
Through the application of these strategies, nurses may help support insulin product transitions while helping to maintain adequate glycaemic control and address potential risks for people with diabetes who require changes in their insulin therapy.

<h2>Explore More 
 &nbsp;</h2>

References

Practical Insulin Transition Guide for Nurses: Titration and Patient Support 

<a href="${link:{uuid:{62efcdcd-db16-49b4-8041-55c212a401fa},repository:{dam},path:{/Portal/UK/Prescribing-Information/Trurapi-PI-UK.pdf}}}">Prescribing Information</a>

<h2>Head-to-head studies Trurapi®&nbsp;vs NovoRapid®</h2>

<h3>Similar PK/PD profile in adults with T1DM1</h3>
PK/PD profiles in the biosimilar Trurapi®, were similar to the UK and EU-approved NovoRapid®&nbsp;and US-approved Novolog®&nbsp;in patients with T1DM.1&nbsp;

<h3>Similar mean HbA1C&nbsp;reduction in adults with T1DM and T2DM2</h3>
At week 26, HbA1C&nbsp;was -0.38% for Trurapi®&nbsp;group vs -0.30% for NovoRapid®/NovoLog®&nbsp;group. Similar mean HbA1C reduction from baseline to Week 26 in Trurapi®&nbsp;and NovoRapid®/Novolog®&nbsp;groups were observed in patients with either T1DM or T2DM.2

<h3>Similar long-term safety and tolerability profiles in adults with T1DM and T2DM2,3</h3>
Similar incidence rates of any hypoglycaemic events (≥1 event) in both the T1DM and overall population were observed in both Trurapi®&nbsp;and NovoRapid®/Novolog®&nbsp;groups.2,3

<h2>Want to know more about the bioequivalence data?</h2>

Watch this short video summarising the similar PK/PD profile (T1DM), efficacy, safety and tolerability profile (T1DM and T2DM) in Trurapi® vs. NovoRapid® from two clinical studies in adults.1,2

Abbreviations

<a href="/uk/type-1-diabetes">SEE MORE FROM SCIENCE</a>

<h3>Trurapi</h3>
Trurapi is indicated for the treatment of diabetes mellitus in adults, adolescents and children aged 1 year and above.&nbsp;

<h3>Patient Website</h3>
Find resources and support for your patients on&nbsp;Trurapi®. Help patients understand the basics of living and staying well with diabetes and how&nbsp;to have a positive start and experience with the&nbsp; medication prescribed to them.

<h2>Get in touch with the Diabetes Team</h2>

Lantus® SoloStar™ 
 (insulin glargine 100 units/mL)

Trurapi®▼ (insulin aspart 100 units/mL)  

Trurapi®▼ (insulin aspart 100 units/mL) Prescribing Information

GENERAL-MEDICINES

T1D-AUTOIMMUNE

DIABETES-CORE

DIABETES-NON-CORE

LANTUS

TOUJEO

INSUMAN-PREMIX

TZEILD

INSULIN-LISPRO-SANOFI

INSUMAN-RAPID

INSUMAN-BASAL

APIDRA

INSULIN-GLARGINE-U100-SANOFI

INSULIN-ASPART-SANOFI

DIABETES

Head to Head Studies

<h3><a href="${link:{uuid:{41d82ab0-c017-4e79-be57-e5930764c364},repository:{dam},path:{/Portal/UK/Prescribing-links/Rezurock-PI-UK.pdf}}}" target="_blank">Prescribing Information UK</a></h3>

<h2>ROCKreal study1</h2>
<h3>ROCKreal shows REZUROCK is an effective option for improving outcomes over BAT for patients with cGVHD.</h3>
Study design:&nbsp;ROCKreal was designed to emulate a phase 3 RCT via casual inference methodology. Consisted of non-interventional chart review from 8 transplant centres in the United States.
Primary end point:&nbsp;Overall response rate (ORR) at 6 months.
<h2>Key Findings:</h2>

Efficacy and safety findings are consistent with ROCKstar trial.

Patients treated with belumosudil had improved outcomes vs BAT, regardless of LOT highlighting its effectiveness.

BAT, best available therapy; RCT, randomised control trial; cGVHD, chronic graft-vs-host-disease; FFS, failure-free survival; LOT, lines of therapy; ORR, overall response rate.

<h2>Primary Endpoint: Overall Response Rate at 6 Months&nbsp;</h2>
<h3>44.2% ratio improvement (11.9% absolute improvement) in the primary endpoint with REZUROCK vs BAT</h3>

Patients were classified as responders (OR=1) if they had a complete or partial response or 50% corticosteroid (CS) dose reduction without disease progression.
Failure was recorded for mixed responses, disease progression, death, treatment switch, or relapse.
BEL, belumosudil, BAT, best available therapy, ORR, overall response rate, CI, confidence interval

<h2>Secondary Endpoint: Failure-Free Survival at 1 year2</h2>
<h3>13.5% improvement in adjusted FFS at 1 year when treated with REZUROCK vs BAT</h3>

The difference in 1-year cumulative incidence of failure was -0.13 (95% CI:[-1, -0.015], p-value: 0.032).​ This indicates a statistically significant reduction in failure events and an increase in 1-year FFS with REZUROCK compared to BAT.

Learn more about REZUROCK

Read Patient Case Studies

Get in touch with the Transplant Team

References

ROCKreal: Real-World Clinical Insights

REZUROCK®▼ (belumosudil) Prescribing Information UK

TRANSPLANT---CORE

REZUROCK

THYMOGLOBULINE

MOZOBIL

TRANSPLANT

<h2>Early diagnosis is key</h2>
The early diagnosis and treatment of Gaucher disease are essential to prevent or reverse severe disease complications.1,2&nbsp;However, when Gaucher is missed, a patient can remain untreated for up to 10 years.2
If left untreated, Gaucher disease can lead to:1,2
<ul>
 <li>Premature death from bleeding complications</li>
 <li>Pulmonary hypertension</li>
 <li>Liver disease</li>
 <li>Sepsis</li>
 <li>Growth failure</li>
 <li>Complications arising from advanced bone disease</li>
 <li>Impact on quality of life</li>
</ul>

In a 2007 study, 136 Gaucher patients from the US, Australia and New Zealand were surveyed. In Australia and New Zealand, 73% or patients were seen by a haematologist-oncologist to obtain a diagnosis. However, a survey of over 400 haematology-oncologists in the US, Australia and New Zealand revealed that:2

80% &nbsp;of haematologists do not consider Gaucher disease in their differential diagnosis.

86% were seen by a haematologist-oncologist in pursuit of a diagnosis in the US.

Splenomegaly and thrombocytopenia are common symptoms of Gaucher disease.3 &nbsp;A recent Italian study found that in patients presenting with either of these symptoms, in addition to one other specified ancillary sign of Gaucher disease, the prevalence rate of Gaucher Type 1 was found to be 3.6%.4 &nbsp;Simple and effective diagnostic algorithms, such as the Cappellini protocol, make it easier to identify patients with suspected Gaucher disease.1

Gaucher disease mimics

For adults of ashkenazi jewish origin1

Diagnostic algorithm

For Adults of non-ashkenazi jewish origin1

For early diagnosis in paediatric patients1

Diagnostic algorithm for adults with splenomegaly and/or thrombocytopenia

Diagnosis of Gaucher disease

RARE-DISEASE

CERDELGA

VENGLUSTAT

CEREZYME

GAUCHER

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