Chen Yuhong, Ning Guang, Wang Changjiang, Gong Yan, Patel Sanjay, Zhang Candice, Izumoto Toshiyasu, Woerle Hans-Juergen, Wang Weiqing
Ruijin Hospital, Shanghai Jiao Tong University School of Medicine Shanghai, China.
The First Affiliated Hospital of Anhui Medical University Hefei, China.
J Diabetes Investig. 2015 Nov;6(6):692-8. doi: 10.1111/jdi.12346. Epub 2015 Apr 4.
AIMS/INTRODUCTION: Asian patients represent a large portion of the global population with type 2 diabetes mellitus, but are underrepresented in trials of glucose-lowering therapies. The present randomized, phase III, placebo-controlled, double-blind, 24-week study evaluated the dipeptidyl peptidase-4 inhibitor, linagliptin, as monotherapy in Asian patients with inadequately controlled type 2 diabetes mellitus.
Patients who were treatment naïve or had been treated with one oral antidiabetes drug were randomized to either linagliptin 5 mg daily or a placebo after washout. The primary end-point was a change from baseline in glycated hemoglobin after 24 weeks.
A total of 300 Asian (87% Chinese) patients with type 2 diabetes mellitus were randomized to linagliptin or placebo at a 2:1 ratio. After 24 weeks of treatment, adjusted mean (standard error) glycated hemoglobin decreased by a placebo-corrected -0.50 ± 0.11 (P < 0.0001). In patients with baseline glycated hemoglobin ≥8.5%, the placebo-corrected decrease in glycated hemoglobin was -0.91 ± 0.20% (P < 0.0001). Adverse events occurred in 28.0 and 28.3% of linagliptin and placebo patients, respectively, but few were drug-related (3.0 and 2.0%, respectively). Hypoglycemia was reported by one linagliptin patient and no placebo patients. Treatment with linagliptin was weight neutral.
In Asian patients with inadequately controlled type 2 diabetes mellitus, linagliptin 5 mg as monotherapy was efficacious and well tolerated over 24 weeks.
目的/引言:亚洲患者在全球2型糖尿病患者中占很大比例,但在降糖治疗试验中的代表性不足。本项随机、III期、安慰剂对照、双盲、为期24周的研究评估了二肽基肽酶-4抑制剂利格列汀作为亚洲2型糖尿病控制不佳患者单药治疗的效果。
未接受过治疗或曾接受过一种口服抗糖尿病药物治疗的患者在洗脱期后被随机分为每日服用5mg利格列汀组或安慰剂组。主要终点是24周后糖化血红蛋白相对于基线的变化。
共有300例亚洲(87%为中国患者)2型糖尿病患者以2:1的比例随机分为利格列汀组或安慰剂组。治疗24周后,校正后的平均(标准误)糖化血红蛋白降低了经安慰剂校正后的-0.50±0.11(P<0.0001)。在基线糖化血红蛋白≥8.5%的患者中,经安慰剂校正后的糖化血红蛋白降低为-0.91±0.20%(P<0.0001)。利格列汀组和安慰剂组分别有28.0%和28.3%的患者发生不良事件,但很少与药物相关(分别为3.0%和2.0%)。有1例利格列汀组患者报告发生低血糖,安慰剂组无患者发生低血糖。利格列汀治疗对体重无影响。
在亚洲2型糖尿病控制不佳的患者中,5mg利格列汀单药治疗在24周内有效且耐受性良好。