Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Diabetes Obes Metab. 2010 Dec;12(12):1113-9. doi: 10.1111/j.1463-1326.2010.01303.x.
The objective of this study was to evaluate the optimal dose, efficacy and safety of a novel dipeptidyl peptidase-4 (DPP-IV) inhibitor, LC15-0444, in Korean subjects with type 2 diabetes mellitus treated by diet and exercise.
This study was a double-blind, randomized, multicenter and parallel-group, dose-range finding study. We enrolled 145 patients (91 men and 54 women) with a median age of 53 years and a median body mass index of 25.1 kg/m(2) . The median baseline fasting plasma glucose (FPG) was 8.1 mmol/l, the median HbA1c was 7.9% and the median time since the diagnosis of diabetes was 3 years. After 2 weeks of an exercise/diet programme followed by 2 weeks of a placebo period, the subjects were randomized to one of the four following groups for a 12-week active treatment period: placebo and 50, 100 or 200 mg of LC15-0444.
All three doses of LC15-0444 significantly reduced the HbA1c from baseline compared to the placebo group (-0.06 vs. -0.98, -0.74 and -0.78% in the placebo and 50, 100 and 200 mg groups, respectively), without a significant difference between the doses. Subjects with a higher baseline HbA1c (≥8.5%) had a greater reduction in HbA1c. Insulin secretory function, as assessed using homeostasis model assessment-beta cell, C-peptide and the insulinogenic index, improved significantly with LC15-0444 treatment. Insulin sensitivity, as assessed using homeostasis model assessment-insulin resistance, also improved significantly after 12 weeks of treatment. The 50 and 200 mg groups had significantly reduced total cholesterol and low-density lipoprotein cholesterol levels at 12 weeks compared to the placebo group. No dosage of LC15-0444 affected weight or waist circumference. The incidences of adverse events were similar in all study subjects.
LC15-0444 monotherapy (50 mg for 12 weeks) improved the HbA1c, FPG level, oral glucose tolerance test results, β-cell function and insulin sensitivity measures, and was well tolerated in Korean subjects with type 2 diabetes.
本研究旨在评估新型二肽基肽酶-4(DPP-4)抑制剂 LC15-0444 在接受饮食和运动治疗的韩国 2 型糖尿病患者中的最佳剂量、疗效和安全性。
这是一项双盲、随机、多中心、平行分组的剂量探索研究。共纳入 145 例患者(91 例男性,54 例女性),中位年龄 53 岁,中位体重指数 25.1 kg/m²。中位基线空腹血糖(FPG)为 8.1 mmol/L,中位糖化血红蛋白(HbA1c)为 7.9%,中位糖尿病确诊时间为 3 年。在进行 2 周的运动/饮食方案后和 2 周的安慰剂期后,将患者随机分为以下 4 组中的一组,进行为期 12 周的活性治疗期:安慰剂和 LC15-0444 的 50、100 或 200mg。
与安慰剂组相比,LC15-0444 的所有三种剂量均能显著降低 HbA1c(与安慰剂组相比,-0.06、-0.74 和-0.78%,50、100 和 200mg 组分别),且剂量间无显著差异。基线 HbA1c 较高(≥8.5%)的患者 HbA1c 降低幅度更大。用稳态模型评估-β细胞、C 肽和胰岛素原指数评估的胰岛素分泌功能均显著改善。用稳态模型评估胰岛素抵抗评估的胰岛素敏感性在治疗 12 周后也显著改善。与安慰剂组相比,50mg 和 200mg 组在 12 周时总胆固醇和低密度脂蛋白胆固醇水平显著降低。LC15-0444 的任何剂量均未影响体重或腰围。所有研究对象的不良事件发生率相似。
LC15-0444 单药治疗(50mg,治疗 12 周)可改善 HbA1c、FPG 水平、口服葡萄糖耐量试验结果、β细胞功能和胰岛素敏感性指标,且在韩国 2 型糖尿病患者中具有良好的耐受性。