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糖尿病相关综合质量终点达成情况:基于两项临床试验的汇总分析比较卡格列净与西格列汀

Diabetes-Related Composite Quality End Point Attainment: Canagliflozin Versus Sitagliptin Based on a Pooled Analysis of 2 Clinical Trials.

作者信息

Bailey Robert A, Vijapurkar Ujjwala, Meininger Gary, Rupnow Marcia F T, Blonde Lawrence

机构信息

Janssen Scientific Affairs, LLC, Raritan, New Jersey.

Janssen Research and Development, LLC, Raritan, New Jersey.

出版信息

Clin Ther. 2015 May 1;37(5):1045-54. doi: 10.1016/j.clinthera.2015.02.020. Epub 2015 Mar 18.

DOI:10.1016/j.clinthera.2015.02.020
PMID:25795432
Abstract

PURPOSE

This post hoc analysis evaluated attainment of diabetes-related composite quality measures (CQMs) with canagliflozin 100 mg, canagliflozin 300 mg, and sitagliptin 100 mg in patients with type 2 diabetes mellitus (T2DM). We used pooled data from two 52-week Phase III clinical trials evaluating the efficacy of canagliflozin 100 mg, canagliflozin 300 mg, and sitagliptin 100 mg.

METHODS

CQMs assessed included the combined attainment of glycosylated hemoglobin (HbA1c), blood pressure (BP), and LDL-C. To assess on-treatment differences at 52 weeks, odds ratios (ORs) and associated 95% CIs were calculated based on a logistic regression model. CQM attainment was assessed in the overall population and for patients with a body mass index ≥25 kg/m(2) at baseline.

FINDINGS

Overall, baseline demographic and disease characteristics were comparable across treatment groups. Proportions of patients with T2DM meeting the CQMs HbA1c <7.0%, BP <130/80 mm Hg, and LDL-C <100 mg/dL and HbA1c <8.0%, BP <140/90 mm Hg, and LDL-C <100 mg/dL were similar at baseline. After 52 weeks of treatment, the proportion of patients meeting both CQMs was similar for canagliflozin 100 mg and sitagliptin 100 mg, and favored canagliflozin 300 mg versus sitagliptin 100 mg. For canagliflozin 300 mg, the OR was 1.79 (95% CI, 1.25-2.58) for the CQM HbA1c <7.0%, BP <130/80 mm Hg, and LDL-C <100 mg/dL; the OR was 1.49 (95% CI, 1.15-1.92) for the CQM HbA1c <8.0%, BP <140/90 mm Hg, and LDL-C <100 mg/dL. CQM attainments for patients with a body mass index ≥25 kg/m(2) were similar to those for the overall population.

IMPLICATIONS

At 52 weeks of treatment, this analysis observed comparable CQM attainment for canagliflozin 100 mg, and superior CQM attainment for canagliflozin 300 mg, compared with sitagliptin 100 mg. ClinicalTrials.gov identifiers are NCT01106677 and NCT01137812.

摘要

目的

本事后分析评估了在2型糖尿病(T2DM)患者中,使用100mg卡格列净、300mg卡格列净和100mg西他列汀时糖尿病相关复合质量指标(CQM)的达标情况。我们使用了两项为期52周的III期临床试验的汇总数据,这些试验评估了100mg卡格列净、300mg卡格列净和100mg西他列汀的疗效。

方法

评估的CQM包括糖化血红蛋白(HbA1c)、血压(BP)和低密度脂蛋白胆固醇(LDL-C)的综合达标情况。为了评估52周时的治疗差异,基于逻辑回归模型计算比值比(OR)和相关的95%置信区间(CI)。在总体人群以及基线体重指数(BMI)≥25kg/m²的患者中评估CQM达标情况。

结果

总体而言,各治疗组的基线人口统计学和疾病特征具有可比性。T2DM患者中,在基线时达到CQM糖化血红蛋白<7.0%(HbA1c<7.0%)、血压<130/80mmHg(BP<130/80mmHg)和低密度脂蛋白胆固醇<100mg/dL(LDL-C<100mg/dL)以及糖化血红蛋白<8.0%(HbA1c<8.0%)、血压<140/90mmHg(BP<140/90mmHg)和低密度脂蛋白胆固醇<100mg/dL的患者比例相似。治疗52周后,100mg卡格列净组和100mg西他列汀组达到两项CQM的患者比例相似,且300mg卡格列净组优于100mg西他列汀组。对于300mg卡格列净,达到CQM糖化血红蛋白<7.0%、血压<1=30/80mmHg和低密度脂蛋白胆固醇<100mg/dL的OR为1.79(95%CI,1.25 - 2.58);达到CQM糖化血红蛋白<8.0%、血压<140/90mmHg和低密度脂蛋白胆固醇<100mg/dL的OR为1.49(95%CI,1.15 - 1.92)。BMI≥25kg/m²患者的CQM达标情况与总体人群相似。

结论

在治疗52周时,该分析观察到,与100mg西他列汀相比,100mg卡格列净的CQM达标情况相当,300mg卡格列净的CQM达标情况更佳。ClinicalTrials.gov标识符为NCT01106677和NCT01137812。

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