Jani Rajendrakumar H, Pai Vikas, Jha Pramod, Jariwala Gunjan, Mukhopadhyay Satinath, Bhansali Anil, Joshi Shashank
1 Clinical R & D, Cadila Healthcare Ltd. , Ahmedabad, India .
Diabetes Technol Ther. 2014 Feb;16(2):63-71. doi: 10.1089/dia.2013.0253. Epub 2013 Oct 18.
Dyslipidemia due to diabetes is characterized by hypertriglyceridemia and reduced levels of high-density lipoprotein cholesterol (HDL-C) and elevated or normal levels of low-density lipoprotein cholesterol (LDL-C) in type 2 diabetes mellitus (T2DM). The objectives of this Phase III study were to evaluate the safety, tolerability, and efficacy of saroglitazar (ZYH1) 2-mg and 4-mg tablets (Lipaglyn™; Zydus Cadila, Ahmedabad, India) compared with placebo in patients with diabetic dyslipidemia who are not controlled with atorvastatin 10 mg therapy.
This was a 16-week prospective, multicenter, randomized, double-blind, placebo controlled, three-arm Phase III study in subjects with hypertriglyceridemia (>200 and <500 mg/dL) with T2DM not controlled with atorvastatin 10 mg. The study consisted of a run-in period of 4 weeks of life-style modification followed by 12 weeks of treatment with saroglitazar (2-mg or 4-mg) or placebo tablets. The primary end point was the change in plasma triglyceride level compared with baseline and the placebo arm at the end of Week 12. The secondary exploratory end points were change in lipid profile and fasting plasma glucose at Week 12. In total, 302 subjects were randomized to receive one of the treatments, saroglitazar 2 mg (n=101) or saroglitazar 4 mg (n=99), or matching placebo (n=102). Patients who received study medication and had undergone at least one post baseline efficacy evaluation were included in the efficacy analysis.
At Week 12, saroglitazar 2-mg and 4-mg tablets significantly reduced mean plasma triglyceride levels by -45.5±3.03% and -46.7±3.02% (mean±SE), respectively, and the difference was significant (P<0.001) compared with placebo. Saroglitazar 2 mg demonstrated significant decrease in levels of non-HDL-C, very LDL-C, total cholesterol, and fasting plasma glucose. Additionally, saroglitazar 4 mg also significantly reduced LDL-C and apolipoprotein B levels. Saroglitazar was found to be safe and well tolerated by patients.
Saroglitazar appeared to be an effective and safe therapeutic option for improving hypertriglyceridemia in patients with T2DM.
糖尿病所致血脂异常的特征为2型糖尿病(T2DM)患者出现高甘油三酯血症、高密度脂蛋白胆固醇(HDL-C)水平降低以及低密度脂蛋白胆固醇(LDL-C)水平升高或正常。本III期研究的目的是评估与安慰剂相比,2毫克和4毫克的沙罗格列扎(ZYH1)片剂(Lipaglyn™;印度艾哈迈达巴德的Zydus Cadila公司)在接受10毫克阿托伐他汀治疗仍未得到控制的糖尿病血脂异常患者中的安全性、耐受性和疗效。
这是一项为期16周的前瞻性、多中心、随机、双盲、安慰剂对照、三臂III期研究,研究对象为甘油三酯水平高于200且低于500毫克/分升的T2DM患者,这些患者接受10毫克阿托伐他汀治疗后病情未得到控制。研究包括4周的生活方式调整导入期,随后是12周的沙罗格列扎(2毫克或4毫克)或安慰剂片剂治疗期。主要终点是第12周结束时与基线和安慰剂组相比血浆甘油三酯水平的变化。次要探索性终点是第12周时血脂谱和空腹血糖的变化。总共302名受试者被随机分配接受以下治疗之一:2毫克沙罗格列扎(n = 101)、4毫克沙罗格列扎(n = 99)或匹配的安慰剂(n = 102)。接受研究药物治疗且至少进行了一次基线后疗效评估的患者纳入疗效分析。
在第12周时,2毫克和4毫克的沙罗格列扎片剂分别使平均血浆甘油三酯水平显著降低了-45.5±3.03%和-46.7±3.02%(均值±标准误),与安慰剂相比差异显著(P < 0.001)。2毫克沙罗格列扎使非HDL-C、极低密度脂蛋白胆固醇、总胆固醇和空腹血糖水平显著降低。此外,4毫克沙罗格列扎也显著降低了LDL-C和载脂蛋白B水平。患者对沙罗格列扎耐受性良好,且安全性高。
沙罗格列扎似乎是改善T2DM患者高甘油三酯血症的一种有效且安全的治疗选择。