Inagaki Nobuya, Goda Maki, Yokota Shoko, Maruyama Nobuko, Iijima Hiroaki
Department of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Mitsubishi Tanabe Pharma Corporation, Tokyo, Japan.
Adv Ther. 2015 Nov;32(11):1085-103. doi: 10.1007/s12325-015-0255-8. Epub 2015 Nov 3.
Sodium glucose co-transporter 2 inhibitors decrease hemoglobin A1c (HbA1c) and blood pressure (BP) and slightly increase low-density lipoprotein cholesterol (LDL-C) in patients with type 2 diabetes mellitus (T2DM). The effects of baseline BP and LDL-C on the safety and efficacy of canagliflozin in patients were analyzed post hoc in a phase III study.
Japanese patients with T2DM were classified by baseline systolic BP (SBP) of <130 or ≥130 mmHg, diastolic BP (DBP) of <80 or ≥80 mmHg, and LDL-C of <120 or ≥120 mg/dL. Canagliflozin was administered daily to patients for 52 weeks at doses of either 100 mg (n = 584) or 200 mg (n = 715). The effects of canagliflozin on the incidence of adverse events (AEs), BP, and LDL-C were evaluated.
No clear differences were observed in overall safety among the subgroups classified by baseline SBP, DBP, or LDL-C, except for a slight imbalance in AEs associated with volume depletion with 200 mg of canagliflozin. The decrease in mean SBP and DBP was evident in subgroups with baseline SBP ≥130 mmHg and DBP ≥80 mmHg. Mean LDL-C was decreased in subgroups with baseline LDL-C ≥120 mg/dL at both canagliflozin doses, and they were slightly increased, but did not exceed 120 mg/dL in subgroups with baseline LDL-C <120 mg/dL. The changes in HbA1c and body weight from those observed at baseline were not different between subgroups classified by SBP, DBP, and LDL-C at either dose.
The present post hoc analysis indicates that canagliflozin is well tolerated irrespective of baseline BP and LDL-C in patients with T2DM.
ClinicalTrials.gov identifier, NCT01387737.
Mitsubishi Tanabe Pharma Corporation.
钠-葡萄糖协同转运蛋白2抑制剂可降低2型糖尿病(T2DM)患者的糖化血红蛋白(HbA1c)和血压(BP),并轻度升高低密度脂蛋白胆固醇(LDL-C)水平。在一项III期研究中,事后分析了基线血压和LDL-C对卡格列净在患者中的安全性和疗效的影响。
将日本T2DM患者按基线收缩压(SBP)<130或≥130 mmHg、舒张压(DBP)<80或≥80 mmHg以及LDL-C<120或≥120 mg/dL进行分类。卡格列净以100 mg(n = 584)或200 mg(n = 715)的剂量每日给药患者52周。评估了卡格列净对不良事件(AE)发生率、血压和LDL-C的影响。
除200 mg卡格列净组与容量耗竭相关的AE略有失衡外,按基线SBP、DBP或LDL-C分类的亚组在总体安全性方面未观察到明显差异。在基线SBP≥130 mmHg和DBP≥80 mmHg的亚组中,平均SBP和DBP的降低较为明显。在两个卡格列净剂量组中,基线LDL-C≥120 mg/dL的亚组平均LDL-C降低,而基线LDL-C<120 mg/dL的亚组平均LDL-C略有升高,但未超过120 mg/dL。在任一剂量下,按SBP、DBP和LDL-C分类的亚组中,HbA1c和体重相对于基线的变化并无差异。
本次事后分析表明,在T2DM患者中,无论基线血压和LDL-C如何,卡格列净的耐受性良好。
ClinicalTrials.gov标识符,NCT01387737。
三菱田边制药株式会社。