Haering Hans-Ulrich, Merker Ludwig, Christiansen Anita Vedel, Roux Flavien, Salsali Afshin, Kim Gabriel, Meinicke Thomas, Woerle Hans J, Broedl Uli C
Department of Internal Medicine IV, University of Tübingen, Otfried-Muller-Str. 10, 72076 Tübingen, Germany.
Diabetes- und Nierenzentrum, Dormagen, Elsa-Brändström-Str. 17, D-41540 Dormagen, Germany.
Diabetes Res Clin Pract. 2015 Oct;110(1):82-90. doi: 10.1016/j.diabres.2015.05.044. Epub 2015 May 29.
This study investigated the long-term efficacy and safety of empagliflozin as add-on to metformin plus sulphonylurea in patients with type 2 diabetes mellitus (T2DM). Of 666 patients treated with empagliflozin 10 mg, empagliflozin 25 mg or placebo once daily for 24 weeks, 472 patients (70.9%) were treated in a double-blind extension trial for ≥52 weeks. Pre-specified exploratory endpoints included changes from baseline in HbA(1c), weight and blood pressure at week 76. At week 76, adjusted mean differences versus placebo in change from baseline in HbA(1c) were -0.7% (-8 mmol/mol) with empagliflozin 10 mg or 25 mg (both p<0.001), in weight were -1.8 kg and -1.6 kg with empagliflozin 10 mg and 25 mg, respectively (both p<0.001), and in systolic blood pressure (SBP) were -2.2 mmHg with empagliflozin 10 mg (p=0.021) and -2.1 mmHg with empagliflozin 25 mg (p=0.029). Sensitivity analyses provided consistent results for HbA1c and weight, but showed no significant difference between empagliflozin and placebo in change from baseline in SBP. Adverse events (AEs) were reported in 81.7%, 82.0% and 81.3% of patients on empagliflozin 10 mg, 25 mg and placebo, respectively. Confirmed hypoglycaemic AEs (glucose ≤3.9 mmol/l and/or requiring assistance) were reported in 23.7%, 19.4% and 15.6% of patients on empagliflozin 10 mg, 25 mg and placebo, respectively; one patient each on empagliflozin 10mg and placebo required assistance. In conclusion, empagliflozin as add-on to metformin plus sulphonylurea for 76 weeks was well tolerated and led to sustained reductions in HbA1c and weight versus placebo. CLINICALTRIALS.GOV: NCT01289990.
本研究调查了恩格列净作为二甲双胍加磺脲类药物的附加治疗药物,用于2型糖尿病(T2DM)患者的长期疗效和安全性。在666例接受每日一次10 mg恩格列净、25 mg恩格列净或安慰剂治疗24周的患者中,472例患者(70.9%)接受了为期≥52周的双盲延长期试验。预先设定的探索性终点包括第76周时糖化血红蛋白(HbA1c)、体重和血压相对于基线的变化。在第76周时,与安慰剂相比,10 mg或25 mg恩格列净组HbA1c相对于基线变化的调整后平均差异为-0.7%(-8 mmol/mol)(均p<0.001),体重分别减轻1.8 kg和1.6 kg(均p<0.001),收缩压(SBP)分别降低2.2 mmHg(10 mg恩格列净组,p=0.021)和2.1 mmHg(25 mg恩格列净组,p=0.029)。敏感性分析对HbA1c和体重得出了一致的结果,但恩格列净组和安慰剂组SBP相对于基线的变化无显著差异。接受10 mg恩格列净、25 mg恩格列净和安慰剂治疗的患者中,不良事件(AE)的报告率分别为81.7%、82.0%和81.3%。确诊的低血糖不良事件(血糖≤3.9 mmol/l和/或需要协助)在接受10 mg恩格列净、25 mg恩格列净和安慰剂治疗的患者中的报告率分别为23.7%、19.4%和15.6%;10 mg恩格列净组和安慰剂组各有1例患者需要协助。总之,恩格列净作为二甲双胍加磺脲类药物的附加治疗药物使用76周耐受性良好,与安慰剂相比可使HbA1c和体重持续降低。临床试验注册编号:NCT01289990。