Emoto Masanori, Terauchi Yasuo, Ozeki Akichika, Oura Tomonori, Takeuchi Masakazu, Imaoka Takeshi
Department of Metabolism, Endocrinology & Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, 545-8585, Japan.
Endocr J. 2015;62(12):1101-14. doi: 10.1507/endocrj.EJ15-0401. Epub 2015 Oct 17.
The goal of this study was to assess the safety and efficacy of 0.75 mg of dulaglutide, a once weekly glucagon-like peptide-1 receptor agonist, in Japanese patients with type 2 diabetes (T2D) on a single oral hypoglycemic agent (OHA). In this phase 3, nonrandomized, open-label, parallel-group, 52-week study, safety and efficacy of once weekly dulaglutide 0.75 mg were assessed in Japanese patients with T2D on a single OHA (sulfonylureas [SU], biguanides [BG], α-glucosidase inhibitors [AGI], thiazolidinedione [TZD], or glinides [GLN]). A total of 394 patients were treated with study drug, and 92.9% completed the 52-week treatment period. The most frequent treatment-emergent adverse events were nasopharyngitis and gastrointestinal disorders, including constipation, diarrhea, and nausea. Incidences of hypoglycemia varied across the combination therapy groups: incidence was greater in patients receiving SU compared with other combinations. No severe hypoglycemic episodes occurred during the study. Increases from baseline in pancreatic and total amylase, lipase, and pulse rate were observed in all 5 combination therapy groups. Significant reductions from baseline in HbA1c were observed in all 5 combination therapy groups (-1.57% to -1.69%, p < 0.001 for all). Mean body weight changes from baseline varied across the combination therapy groups: a significant increase was observed in combination with TZD, there were no significant changes in combination with SU or GLN, and significant reductions were observed in combination with BG or AGI. Once weekly dulaglutide 0.75 mg in combination with a single OHA was overall well tolerated and improved glycemic control in Japanese patients with T2D.
本研究的目的是评估每周一次注射0.75毫克度拉糖肽(一种胰高血糖素样肽-1受体激动剂),对使用单一口服降糖药(OHA)的日本2型糖尿病(T2D)患者的安全性和有效性。在这项3期、非随机、开放标签、平行组、为期52周的研究中,评估了每周一次注射0.75毫克度拉糖肽对使用单一OHA(磺脲类药物[SU]、双胍类药物[BG]、α-葡萄糖苷酶抑制剂[AGI]、噻唑烷二酮类药物[TZD]或格列奈类药物[GLN])的日本T2D患者的安全性和有效性。共有394例患者接受了研究药物治疗,92.9%的患者完成了52周的治疗期。最常见的治疗中出现的不良事件是鼻咽炎和胃肠道疾病,包括便秘、腹泻和恶心。低血糖的发生率在联合治疗组中各不相同:与其他联合治疗组相比,接受SU治疗的患者发生率更高。研究期间未发生严重低血糖事件。在所有5个联合治疗组中,均观察到胰腺及总淀粉酶、脂肪酶和脉搏率较基线水平升高。在所有5个联合治疗组中,均观察到糖化血红蛋白(HbA1c)较基线水平显著降低(-1.57%至-1.69%,所有组p<0.001)。联合治疗组的平均体重较基线的变化各不相同:与TZD联合使用时观察到显著增加,与SU或GLN联合使用时无显著变化,与BG或AGI联合使用时观察到显著降低。每周一次注射0.75毫克度拉糖肽联合单一OHA,总体耐受性良好,可改善日本T2D患者的血糖控制。