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利拉鲁肽治疗 2 型糖尿病合并终末期肾病患者的安全性和有效性:一项前瞻性、随机、安慰剂对照、双盲、平行干预研究的方案。

Safety and efficacy of liraglutide in patients with type 2 diabetes and end-stage renal disease: protocol for an investigator-initiated prospective, randomised, placebo-controlled, double-blinded, parallel intervention study.

机构信息

Department of Nephrology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.

出版信息

BMJ Open. 2013 Apr 26;3(4). doi: 10.1136/bmjopen-2013-002764. Print 2013.

Abstract

INTRODUCTION

Diabetes is the leading cause of end-stage renal disease (ESRD). Owing to renal clearance, several antidiabetic agents cannot be used in patients with ESRD. The present protocol describes an investigator-initiated trial aiming to test safety and efficacy of treatment with the glucagon-like peptide-1 receptor agonist liraglutide in patients with type 2 diabetes and dialysis-dependent ESRD.

METHODS AND ANALYSIS

Twenty patients with type 2 diabetes and ESRD will be compared with 20 matched patients with type 2 diabetes and normal kidney function in a randomised, parallel, placebo-controlled (1 : 1), double-blinded setting. All participants will receive 12 weeks of daily treatment with liraglutide/placebo in an individually titrated dose of 0.6, 1.2 or 1.8 mg. Over nine visits, plasma liraglutide, glycaemic control, β-cell response, cardiovascular parameters, various biomarkers and adverse events will be assessed. The primary endpoint will be evaluated from dose-corrected plasma trough liraglutide concentration at the final trial visit to determine potential accumulation in the ESRD group.

ETHICS AND DISSEMINATION

The study has been approved by the Danish Medicines Agency, the Scientific-Ethical Committee of the Capital Region of Denmark and the Danish Data Protection Agency. An external monitoring committee (The Good Clinical Practice Unit at Copenhagen University Hospitals) will oversee the study. The results of the study will be presented at national and international scientific meetings, and publications will be submitted to peer-reviewed journals.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT01394341.

摘要

简介

糖尿病是终末期肾病(ESRD)的主要病因。由于肾脏清除作用,一些抗糖尿病药物不能用于 ESRD 患者。本方案描述了一项由研究者发起的试验,旨在测试胰高血糖素样肽-1 受体激动剂利拉鲁肽治疗 2 型糖尿病和透析依赖性 ESRD 患者的安全性和疗效。

方法和分析

20 例 2 型糖尿病和 ESRD 患者将在随机、平行、安慰剂对照(1:1)、双盲设置中与 20 例匹配的 2 型糖尿病和正常肾功能患者进行比较。所有参与者将接受为期 12 周的利拉鲁肽/安慰剂个体化滴定剂量(0.6、1.2 或 1.8 mg)的每日治疗。在九次就诊中,将评估血浆利拉鲁肽、血糖控制、β细胞反应、心血管参数、各种生物标志物和不良事件。主要终点将根据最终试验访视时校正剂量后的血浆利拉鲁肽谷浓度进行评估,以确定 ESRD 组的潜在蓄积情况。

伦理和传播

该研究已获得丹麦药品管理局、丹麦首都地区科学伦理委员会和丹麦数据保护局的批准。一个外部监测委员会(哥本哈根大学医院的良好临床实践单位)将监督该研究。该研究的结果将在国家和国际科学会议上公布,并将向同行评议期刊提交出版物。

试验注册

ClinicalTrials.gov 标识符:NCT01394341。

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