Department of Diabetes and Clinical Nutrition, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Diabetes Obes Metab. 2013 Sep;15(9):833-43. doi: 10.1111/dom.12110. Epub 2013 May 3.
To evaluate the long-term safety and efficacy of linagliptin as add-on therapy to one approved oral antidiabetic drug (OAD) in Japanese patients with type 2 diabetes mellitus and insufficient glycaemic control.
This 52-week, multicentre, open-label, parallel-group study evaluated once-daily linagliptin 5 mg as add-on therapy to one OAD [biguanide, glinide, glitazone, sulphonylurea (SU) or α-glucosidase inhibitors (A-GI)] in 618 patients. After a 2-week run-in, patients on SU or A-GI were randomized to either linagliptin (once daily, 5 mg) or metformin (twice or thrice daily, up to 2250 mg/day) as add-on therapy. Patients receiving the other OADs received linagliptin add-on therapy (non-randomized).
Adverse events were mostly mild or moderate, and rates were similar across all groups. Hypoglycaemic events were rare, except in the SU group. Overall, 26 (5.8%) hypoglycaemic events were reported in patients receiving linagliptin (non-randomized). Hypoglycaemic events were similar for linagliptin and metformin added to A-GI (1/61 vs. 2/61, respectively) or SU (17/124 vs. 10/63, respectively). Significant reductions in glycated haemoglobin (HbA1c) levels (between -0.7 and -0.9%) occurred throughout the study period for the background therapy groups that received linagliptin (baseline HbA1c 7.9-8.1%). The decline in HbA1c levels was indistinguishable between linagliptin and metformin groups when administered as add-on therapy to A-GI or SU.
Once-daily linagliptin showed safety and tolerability over 1 year and provided effective add-on therapy leading to significant HbA1c reductions, similar to metformin, over 52 weeks in Japanese patients.
评估利拉利汀作为附加疗法用于治疗血糖控制不佳的日本 2 型糖尿病患者,这些患者正在接受一种已批准的口服降糖药(OAD)治疗。
这是一项为期 52 周、多中心、开放性、平行分组研究,评估了每日一次利拉利汀 5mg 作为附加疗法,联合一种 OAD[双胍类、格列奈类、格列酮类、磺酰脲类(SU)或 α-葡萄糖苷酶抑制剂(A-GI)]治疗 618 例患者。在 2 周导入期后,接受 SU 或 A-GI 治疗的患者被随机分为利拉利汀(每日一次,5mg)或二甲双胍(每日两次或三次,最高 2250mg/天)作为附加疗法。接受其他 OAD 治疗的患者接受利拉利汀附加疗法(非随机)。
不良事件大多为轻度或中度,且各治疗组的发生率相似。除 SU 组外,低血糖事件罕见。接受利拉利汀(非随机)治疗的患者共报告了 26(5.8%)例低血糖事件。利拉利汀与二甲双胍分别添加至 A-GI(各 1/61 例)或 SU(各 17/124 例)时的低血糖事件发生率相似。接受利拉利汀治疗的背景治疗组在整个研究期间的糖化血红蛋白(HbA1c)水平均显著降低(降幅为-0.7 至-0.9%)(基线 HbA1c 为 7.9-8.1%)。当利拉利汀与二甲双胍分别作为附加疗法添加至 SU 或 SU 时,HbA1c 水平的下降在两组之间无差异。
在日本患者中,每日一次利拉利汀治疗 1 年以上具有安全性和耐受性,与二甲双胍联合治疗 52 周可有效降低 HbA1c 水平。