Kansai Electric Power Hospital, Osaka, Japan.
Diabetes Obes Metab. 2012 Oct;14(10):927-36. doi: 10.1111/j.1463-1326.2012.01620.x. Epub 2012 Jun 5.
To evaluate the efficacy and safety of alogliptin added to metformin versus metformin monotherapy in Japanese patients with type 2 diabetes who achieved inadequate glycaemic control on metformin (500 or 750 mg/day) + diet/exercise.
In a randomized, double-blind trial, 288 patients with type 2 diabetes mellitus T2DM received either 12.5 or 25 mg alogliptin once daily + metformin or placebo + metformin for 12 weeks. Thereafter, 276 patients continued on one of the two alogliptin dosages + metformin in an open-label extension for 40 weeks. The primary efficacy endpoint in the randomized, double-blind phase was the change in HbA1c from baseline (week 0) to the end of treatment (week 12). The primary endpoint during the long-term extension phase was adverse events.
After 12 weeks both dosages of alogliptin + metformin produced significantly greater changes from baseline in HbA1c than placebo (metformin monotherapy: with changes in LS means - 0.55 and - 0.64% vs. 0.22%, respectively; p < 0.0001). Incidences of adverse effects were comparable between groups, with no increases in hypoglycaemia. Over 52 weeks, there were no safety or tolerability concerns with alogliptin when added to metformin.
Alogliptin 12.5 and 25 mg once daily was safe and effective when added to metformin (500 or 750 mg/day) in Japanese patients with inadequately controlled type 2 diabetes on metformin alone.
评估在二甲双胍(500 或 750mg/天)+饮食/运动治疗血糖控制不佳的日本 2 型糖尿病患者中,加用阿格列汀对比二甲双胍单药治疗的疗效和安全性。
在一项随机、双盲试验中,288 例 2 型糖尿病患者接受每日一次 12.5 或 25mg 阿格列汀+二甲双胍或安慰剂+二甲双胍治疗 12 周。此后,276 例患者继续在开放标签扩展期接受两种阿格列汀剂量+二甲双胍治疗 40 周。随机、双盲阶段的主要疗效终点是从基线(第 0 周)到治疗结束(第 12 周)时 HbA1c 的变化。长期扩展阶段的主要终点是不良事件。
12 周后,两种剂量的阿格列汀+二甲双胍治疗与安慰剂(二甲双胍单药治疗:LS 均值变化分别为-0.55%和-0.64%,与 0.22%相比,p<0.0001)相比,均能显著降低 HbA1c 水平。各组不良反应发生率相当,低血糖无增加。在 52 周的研究期间,阿格列汀联合二甲双胍未出现安全性或耐受性问题。
在单独使用二甲双胍血糖控制不佳的日本 2 型糖尿病患者中,每日一次加用 12.5 和 25mg 阿格列汀与二甲双胍(500 或 750mg/天)联合使用是安全有效的。