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评估维格列汀的总体安全性和耐受性:大型安全数据库汇总分析与个体研究评估的价值

Assessing the general safety and tolerability of vildagliptin: value of pooled analyses from a large safety database versus evaluation of individual studies.

作者信息

Schweizer Anja, Dejager Sylvie, Foley James E, Kothny Wolfgang

机构信息

Novartis Pharma AG, Basel, Switzerland.

出版信息

Vasc Health Risk Manag. 2011;7:49-57. doi: 10.2147/VHRM.S16925. Epub 2011 Feb 4.

Abstract

AIM

Analyzing safety aspects of a drug from individual studies can lead to difficult-to-interpret results. The aim of this paper is therefore to assess the general safety and tolerability, including incidences of the most common adverse events (AEs), of vildagliptin based on a large pooled database of Phase II and III clinical trials.

METHODS

Safety data were pooled from 38 studies of ≥ 12 to ≥ 104 weeks' duration. AE profiles of vildagliptin (50 mg bid; N = 6116) were evaluated relative to a pool of comparators (placebo and active comparators; N = 6210). Absolute incidence rates were calculated for all AEs, serious AEs (SAEs), discontinuations due to AEs, and deaths.

RESULTS

Overall AEs, SAEs, discontinuations due to AEs, and deaths were all reported with a similar frequency in patients receiving vildagliptin (69.1%, 8.9%, 5.7%, and 0.4%, respectively) and patients receiving comparators (69.0%, 9.0%, 6.4%, and 0.4%, respectively), whereas drug-related AEs were seen with a lower frequency in vildagliptin-treated patients (15.7% vs 21.7% with comparators). The incidences of the most commonly reported specific AEs were also similar between vildagliptin and comparators, except for increased incidences of hypoglycemia, tremor, and hyperhidrosis in the comparator group related to the use of sulfonylureas.

CONCLUSIONS

The present pooled analysis shows that vildagliptin was overall well tolerated in clinical trials of up to >2 years in duration. The data further emphasize the value of a pooled analysis from a large safety database versus assessing safety and tolerability from individual studies.

摘要

目的

从个体研究分析一种药物的安全性可能会得出难以解释的结果。因此,本文的目的是基于一个包含II期和III期临床试验的大型汇总数据库,评估维格列汀的总体安全性和耐受性,包括最常见不良事件(AE)的发生率。

方法

安全性数据来自38项持续时间≥12周至≥104周的研究。相对于一组对照药(安慰剂和活性对照药;N = 6210),评估了维格列汀(50 mg,每日两次;N = 6116)的AE概况。计算了所有AE、严重AE(SAE)、因AE停药和死亡的绝对发生率。

结果

接受维格列汀的患者(分别为69.1%、8.9%、5.7%和0.4%)和接受对照药的患者(分别为69.0%、9.0%、6.4%和0.4%)报告的总体AE、SAE、因AE停药和死亡的频率相似,而维格列汀治疗的患者中与药物相关的AE出现频率较低(15.7%,对照药为21.7%)。除了与使用磺脲类药物相关的对照组中低血糖、震颤和多汗症发生率增加外,维格列汀和对照药之间最常报告的特定AE的发生率也相似。

结论

目前的汇总分析表明,在长达2年以上的临床试验中,维格列汀总体耐受性良好。数据进一步强调了来自大型安全数据库的汇总分析相对于从个体研究评估安全性和耐受性的价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/82e1/3049539/43a928eb7a65/vhrm-7-049f1.jpg

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