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达格列净单药治疗对饮食和运动控制不佳的日本2型糖尿病患者的疗效及安全性

Efficacy and safety of dapagliflozin monotherapy in Japanese patients with type 2 diabetes inadequately controlled by diet and exercise.

作者信息

Kaku K, Kiyosue A, Inoue S, Ueda N, Tokudome T, Yang J, Langkilde A M

机构信息

Department of Internal Medicine, Kawasaki Medical School, Okayama, Japan.

出版信息

Diabetes Obes Metab. 2014 Nov;16(11):1102-10. doi: 10.1111/dom.12325. Epub 2014 Jul 8.

Abstract

AIMS

To evaluate the efficacy and safety of the selective sodium glucose co-transporter 2 inhibitor dapagliflozin in Japanese patients with type 2 diabetes mellitus (T2DM) inadequately controlled by diet and exercise.

METHODS

Patients received placebo or dapagliflozin (5 or 10 mg) once daily for 24 weeks. The primary outcome measure was change from baseline in glycated haemoglobin (HbA1c).

RESULTS

Patients (N = 261) had modestly elevated baseline HbA1c (mean ≈ 7.5%) and most had mild or moderate renal impairment (estimated glomerular filtration rate range 43-103 ml/min/1.73 m(2)). Greater reductions in mean HbA1c level were observed with dapagliflozin (5 mg, -0.41%; 10 mg, -0.45%) than with placebo (-0.06%) at week 24 and these were greater in patients with higher baseline HbA1c levels. Fasting plasma glucose (FPG) was also significantly reduced with dapagliflozin (5 mg, -8.6 mg/dl; 10 mg, -13.7 mg/dl) compared with placebo (+5.8 mg/dl). Dapagliflozin significantly reduced body weight (5 mg, -2.13 kg; 10 mg, -2.22 kg) compared with placebo (-0.84 kg). Overall, 47.7 and 64.8% of patients with dapagliflozin 5 and 10 mg, respectively, and 51.7% with placebo experienced ≥ 1 adverse event, mostly mild or moderate, and unrelated to study treatment. Two patients on dapagliflozin 10 mg reported hypoglycaemia. Four patients across all groups reported events suggestive of genital infection and four of urinary tract infection. No events of pyelonephritis were reported.

CONCLUSION

Dapagliflozin (5 and 10 mg) was well tolerated and effective in reducing HbA1c, FPG and body weight over 24 weeks in Japanese patients with T2DM inadequately controlled by diet and exercise.

摘要

目的

评估选择性钠-葡萄糖协同转运蛋白2抑制剂达格列净对饮食和运动控制不佳的日本2型糖尿病(T2DM)患者的疗效和安全性。

方法

患者每日一次接受安慰剂或达格列净(5或10毫克)治疗,为期24周。主要结局指标为糖化血红蛋白(HbA1c)自基线的变化。

结果

患者(N = 261)基线HbA1c轻度升高(平均约7.5%),多数患者有轻度或中度肾功能损害(估计肾小球滤过率范围为43 - 103毫升/分钟/1.73平方米)。在第24周时,与安慰剂组(-0.06%)相比,达格列净组(5毫克组,-0.41%;10毫克组,-0.45%)的平均HbA1c水平降低幅度更大,且基线HbA1c水平较高的患者降低幅度更大。与安慰剂组(+5.8毫克/分升)相比,达格列净组(5毫克组,-8.6毫克/分升;10毫克组,-13.7毫克/分升)的空腹血糖(FPG)也显著降低。与安慰剂组(-0.84千克)相比,达格列净组(5毫克组,-2.13千克;10毫克组,-2.22千克)的体重显著降低。总体而言,达格列净5毫克组和10毫克组分别有47.7%和64.8%的患者以及安慰剂组51.7%的患者发生≥1次不良事件,大多为轻度或中度,且与研究治疗无关。两名服用达格列净10毫克的患者报告发生低血糖。所有组中有4名患者报告有生殖器感染迹象,4名患者报告有尿路感染。未报告肾盂肾炎事件。

结论

在饮食和运动控制不佳的日本T2DM患者中,达格列净(5毫克和10毫克)在24周内耐受性良好,可有效降低HbA1c、FPG和体重。

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