Evidence map›Paper›PMID 32539810›Full record

ArticleBMC endocrine disorders2020

Study rationale and design of the EANITIATE study (EmpAgliflozin compared to NPH Insulin for sTeroId diAbeTEs) - a randomized, controlled, multicenter trial of safety and efficacy of treatment with empagliflozin compared with NPH-insulin in patients with newly onset diabetes following initiation of glucocorticoid treatment.

Carina Kirstine Klarskov, Helga Holm Schultz, Frederik Persson, Tomas Møller Christensen, Thomas Peter Almdal, Ole Snorgaard, Katrine Bagge Hansen, Ulrik Pedersen-Bjergaard, Peter Lommer Kristensen

Open access · goldAbstract readClinical Trial Protocol
In one paragraph

Article in BMC endocrine disorders, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
1.0field-weighted citation impact, top 23% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.

  1. Glucocorticoid-Induced Hyperglycemia Including Dexamethasone-Associated Hyperglycemia in COVID-19 Infection: A Systematic Review.Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 2022
    Pooled it
  2. Trial
  3. Review
  4. Glucocorticoid-Induced Hyperglycemia: A Neglected Problem.Endocrinology and metabolism (Seoul, Korea) · 2024
    Review
  5. Article
  6. Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 6 institutions in 1 country.

Carina Kirstine KlarskovDepartment of Endocrinology and Nephrology, Nordsjaellands Hospital, Dyrehavevej 29, DK-3400, Hilleroed, Denmark. Carina.kirstine.klarskov@regionh.dk.ORCID http://orcid.org/0000-0001-7702-8595
Helga Holm SchultzDepartment of Oncology at Herlev-Gentofte University Hospital, Herlev Ringvej 75, DK-2730, Herlev, Denmark.
Frederik PerssonSteno Diabetes Center Copenhagen, Niels Steensens vej 2, DK-2820, Gentofte, Denmark.
Tomas Møller ChristensenDepartment of Endocrinology, Bispebjerg University Hospital, Bispebjergbakke 23, DK-2400, Copenhagen, Denmark.
Thomas Peter AlmdalDepartment of Endocrinology, Copenhagen University Hospital (Rigshospitalet), Blegdamsvej 9, DK-2100, Copenhagen, Denmark.
Ole SnorgaardHvidovre University Hospital, Kettegård Alle 30, DK-2650, Hvidovre, Denmark.
Katrine Bagge HansenSteno Diabetes Center Copenhagen, Niels Steensens vej 2, DK-2820, Gentofte, Denmark.
Ulrik Pedersen-BjergaardDepartment of Endocrinology and Nephrology, Nordsjaellands Hospital, Dyrehavevej 29, DK-3400, Hilleroed, Denmark.
Peter Lommer KristensenDepartment of Endocrinology and Nephrology, Nordsjaellands Hospital, Dyrehavevej 29, DK-3400, Hilleroed, Denmark.
Nordsjællands Hospital · DKSteno Diabetes Centers · DKBispebjerg Hospital · DKCopenhagen University Hospital · DKHvidovre Hospital · DKUniversity of Copenhagen · DK

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA well-known metabolic side effect from treatment with glucocorticoids is glucocorticoid-induced diabetes mellitus (GIDM). Guidelines on the management of GIDM in hospitalized patients (in the non-critical care setting), recommend initiation of insulin therapy. The scientific basis and evidence for superiority of insulin therapy over other glucose lowering therapies is however poor and associated with episodes of both hypo- and hyperglycaemia. There is an unmet need for an easier, safe and convenient therapy for glucocorticoid-induced diabetes.

methodsEANITIATE is a Danish, open, prospective, multicenter, randomized (1:1), parallel group study in patients with new-onset diabetes following treatment with glucocorticoids (> 20 mg equivalent prednisolone dose/day) with blinded endpoint evaluation (PROBE design). Included patients are randomized to either a Sodium-Glucose-Cotransporter 2 (SGLT2) inhibitor or neutral protamin Hagedorn (NPH) insulin and followed for 30 days. Blinded continuous glucose monitoring (CGM) will provide data for the primary endpoint (mean daily blood glucose) and on glucose fluctuations in the two treatment arms. Secondary endpoints are patient related outcomes, hypoglycaemia, means and measures of variation for all values and for time specific glucose values. This is a non-inferiority study with the intent to demonstrate that treatment with empagliflozin is not inferior to treatment with NPH insulin when it comes to glycemic control and side effects. DISCUSSION: This novel approach to management of glucocorticoid-induced hyperglycemia has not been tested before and if SGLT2 inhibition with empaglifozin compared to NPH-insulin is a safe, effective and resource sparing treatment for GIDM, it has the potential to improve the situation for affected patients and have health economic benefits.

trial registrationwww.clinicaltrialsregister.eu no.: 2018-002640-82. Prospectively registered November 20th. 2018. Date of first patient enrolled: June 4th. 2019. This protocol article is based on the EANITATE protocol version 1.3, dated 29. January 2018.

Indexed as

Benzhydryl CompoundsBlood GlucoseBlood Glucose Self-MonitoringDiabetes Mellitus, Type 2Equivalence Trials as TopicGlucocorticoidsGlucosidesGlycemic ControlHumansHypoglycemiaHypoglycemic AgentsInsulin, IsophaneMonitoring, PhysiologicMulticenter Studies as TopicPatient Reported Outcome MeasuresRandomized Controlled Trials as TopicBenzhydryl CompoundsBlood GlucoseempagliflozinGlucocorticoidsGlucosidesHypoglycemic AgentsInsulin, IsophaneSodium-Glucose Transporter 2 InhibitorsCGMDiabetesGlucocorticoidsNPH-insulinRCTSGLT2-i

Identifiers

PMID32539810
PMCPMC7296645
OpenAlexW3035189978

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.