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胰高血糖素样肽-1受体激动剂利拉鲁肽添加至胰岛素治疗对1型糖尿病血糖控制不佳患者的疗效和安全性——一项随机、双盲、安慰剂对照研究方案:Lira-1研究

Efficacy and safety of the glucagon-like peptide-1 receptor agonist liraglutide added to insulin therapy in poorly regulated patients with type 1 diabetes--a protocol for a randomised, double-blind, placebo-controlled study: the Lira-1 study.

作者信息

Dejgaard Thomas Fremming, Knop Filip Krag, Tarnow Lise, Frandsen Christian Seerup, Hansen Tanja Stenbæk, Almdal Thomas, Holst Jens Juul, Madsbad Sten, Andersen Henrik Ullits

机构信息

Steno Diabetes Center, Gentofte, Denmark Department of Endocrinology, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark.

Center for Diabetes Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark Faculty of Health and Medical Sciences, Department of Biomedical Sciences, The NNF Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark.

出版信息

BMJ Open. 2015 Apr 2;5(4):e007791. doi: 10.1136/bmjopen-2015-007791.

Abstract

INTRODUCTION

Intensive insulin therapy is recommended for the treatment of type 1 diabetes (T1D). Hypoglycaemia and weight gain are the common side effects of insulin treatment and may reduce compliance. In patients with insulin-treated type 2 diabetes, the addition of glucagon-like peptide-1 receptor agonist (GLP-1RA) therapy has proven effective in reducing weight gain and insulin dose. The present publication describes a protocol for a study evaluating the efficacy and safety of adding a GLP-1RA to insulin treatment in overweight patients with T1D in a randomised, double-blinded, controlled design.

METHODS AND ANALYSIS

In total, 100 patients with type 1 diabetes, poor glycaemic control (glycated haemoglobin (HbA1c) >8%) and overweight (body mass index >25 kg/m(2)) will be randomised to either liraglutide 1.8 mg once daily or placebo as an add-on to intensive insulin therapy in this investigator initiated, double-blinded, placebo-controlled parallel study. The primary end point is glycaemic control as measured by changes in HbA1c. Secondary end points include changes in the insulin dose, hypoglyacemic events, body weight, lean body mass, fat mass, food preferences and adverse events. Glycaemic excursions, postprandial glucagon levels and gastric emptying rate during a standardised liquid meal test will also be studied.

ETHICS AND DISSEMINATION

The study is approved by the Danish Medicines Authority, the Regional Scientific-Ethical Committee of the Capital Region of Denmark and the Data Protection Agency. The study will be carried out under the surveillance and guidance of the good clinical practice (GCP) unit at Copenhagen University Hospital Bispebjerg in accordance with the ICH-GCP guidelines and the Helsinki Declaration.

TRIAL REGISTRATION NUMBER

NCT01612468.

摘要

引言

强化胰岛素治疗被推荐用于1型糖尿病(T1D)的治疗。低血糖和体重增加是胰岛素治疗的常见副作用,可能会降低治疗依从性。在接受胰岛素治疗的2型糖尿病患者中,添加胰高血糖素样肽-1受体激动剂(GLP-1RA)治疗已被证明可有效减轻体重增加并减少胰岛素剂量。本出版物描述了一项研究方案,该研究采用随机、双盲、对照设计,评估在超重的T1D患者中,在胰岛素治疗基础上加用GLP-1RA的疗效和安全性。

方法与分析

在这项由研究者发起的、双盲、安慰剂对照的平行研究中,总共100例血糖控制不佳(糖化血红蛋白(HbA1c)>8%)且超重(体重指数>25kg/m²)的1型糖尿病患者将被随机分为两组,一组每天一次皮下注射1.8mg利拉鲁肽,另一组注射安慰剂,作为强化胰岛素治疗的附加治疗。主要终点是通过HbA1c的变化来衡量的血糖控制情况。次要终点包括胰岛素剂量的变化、低血糖事件、体重、瘦体重、脂肪量、食物偏好和不良事件。还将研究标准化流食试验期间的血糖波动、餐后胰高血糖素水平和胃排空率。

伦理与传播

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数据保护局的批准。该研究将在哥本哈根大学医院比斯佩布杰格的良好临床实践(GCP)单位的监督和指导下进行,遵循国际人用药品注册技术协调会(ICH)-GCP指南和《赫尔辛基宣言》。

试验注册号

NCT01612468。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d58f/4390685/ba69f60be11a/bmjopen2015007791f01.jpg

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