Endocrinology Center, Baylor Medical Center, Dallas, Texas, USA.
Obesity (Silver Spring). 2013 Feb;21(2):238-47. doi: 10.1002/oby.20042.
Therapies that lower blood glucose and provide weight loss may provide meaningful benefits for obese patients with type 2 diabetes mellitus (T2DM). This study assessed the efficacy of taspoglutide compared with placebo on glycemic control and weight in obese patients with T2DM inadequately controlled with metformin monotherapy.
In a 24-week, randomized, double-blind, placebo-controlled, multicenter trial, obese adults with T2DM were randomized (1:1) to weekly subcutaneous taspoglutide 20 mg (10 mg for first 4 weeks) (n = 154) or placebo (n = 151) for 24 weeks. Efficacy measures included hemoglobin A1c (HbA1c) levels, body weight, percentage of patients achieving HbA1c ≤6.5 and ≤7.0%, and fasting plasma glucose (FPG). Adverse events (AEs) were assessed.
Mean baseline HbA1c was 7.55% and mean baseline BMI was 36.7 kg/m(2) . HbA1c reductions from baseline were significantly greater with taspoglutide than placebo (least square mean [LSMean], -0.81% vs. -0.09%; P < 0.0001). Weight loss at week 24 was significantly greater with taspoglutide than placebo (LSMean, -3.16 vs. -1.85 kg; P < 0.01). In the taspoglutide and placebo groups, target HbA1c levels (≤6.5%) were achieved by 49 and 16% of patients, respectively, while 72 and 36% achieved HbA1c levels ≤7%. Decreases in FPG were significantly greater with taspoglutide than placebo (-23.59 vs. 0.09 mg/dl; P < 0.0001). Nausea and vomiting were the most common AEs associated with taspoglutide, but tended to be transient and generally mild or moderate.
In obese patients with T2DM, once-weekly taspoglutide provided the combined benefits of glycemic control and weight loss.
对于血糖控制不佳的肥胖 2 型糖尿病(T2DM)患者,降低血糖并减轻体重的治疗方法可能具有重要意义。本研究评估了每周皮下注射 20 毫克塔斯格鲁肽(前 4 周 10 毫克)与安慰剂相比,在二甲双胍单药治疗血糖控制不佳的肥胖 T2DM 患者中的疗效。
在一项为期 24 周的随机、双盲、安慰剂对照、多中心试验中,将 2 型糖尿病肥胖患者随机(1:1)分为每周皮下注射 20 毫克塔斯格鲁肽(前 4 周 10 毫克)(n=154)或安慰剂(n=151)组,共 24 周。疗效评估指标包括糖化血红蛋白(HbA1c)水平、体重、达到 HbA1c≤6.5%和≤7.0%的患者比例以及空腹血糖(FPG)。评估不良事件(AE)。
平均基线 HbA1c 为 7.55%,平均基线 BMI 为 36.7kg/m2。与安慰剂相比,塔斯格鲁肽组的 HbA1c 降低幅度明显更大(最小二乘均值[LSMean],-0.81%比-0.09%;P<0.0001)。与安慰剂相比,塔斯格鲁肽组 24 周时体重下降更明显(LSMean,-3.16 比-1.85kg;P<0.01)。在塔斯格鲁肽和安慰剂组中,分别有 49%和 16%的患者达到了目标 HbA1c 水平(≤6.5%),而 72%和 36%的患者达到了 HbA1c 水平(≤7.0%)。与安慰剂相比,塔斯格鲁肽组的 FPG 降低更明显(-23.59 比 0.09mg/dl;P<0.0001)。与塔斯格鲁肽相关的最常见 AE 是恶心和呕吐,但通常为一过性,且一般为轻度或中度。
在肥胖的 T2DM 患者中,每周一次的塔斯格鲁肽可同时实现血糖控制和体重减轻的效果。