Onishi Yukiko, Oura Tomonori, Nishiyama Hiroshi, Ohyama Sumika, Takeuchi Masakazu, Iwamoto Noriyuki
The Institute for Adult Diseases, Asahi Life Foundation, Tokyo, Japan.
Endocr J. 2016;63(3):263-73. doi: 10.1507/endocrj.EJ15-0518. Epub 2015 Dec 23.
The efficacy and tolerability of once weekly dulaglutide 0.75 mg in Japanese patients with type 2 diabetes (T2D) were evaluated by subgroups defined by key demographic characteristics. This post hoc analysis included data from patients who received dulaglutide 0.75 mg for up to 26 weeks in three phase 3 trials (one open-label, randomized; one double-blind and open-label, randomized; one open-label, nonrandomized). Patients were classified into subgroups on the basis of sex (male, female), age (<65, ≥65 years), body weight (<70, ≥70 kg), body mass index (BMI; <25, ≥25 kg/m(2)), duration of diabetes (<7, ≥7 years), HbA1c (≤8.5, >8.5%), use of concomitant sulfonylurea (yes, no), and use of concomitant biguanide (yes, no). Efficacy measures analyzed were changes from baseline in HbA1c and body weight and percentages of patients achieving HbA1c <7.0%. Safety measures analyzed were incidence of hypoglycemia and nausea and change from baseline in seated pulse rate. A total of 855 patients were analyzed. Once weekly dulaglutide 0.75 mg improved blood glucose control as measured by HbA1c regardless of patient characteristics; patients with higher baseline HbA1c values had greater improvements compared to patients with lower baseline values. Weight loss was greater in patients with lower baseline HbA1c and in patients taking concomitant biguanides. Concomitant use of sulfonylureas had the greatest effect on the incidence of hypoglycemia. Treatment of T2D with once weekly dulaglutide 0.75 mg for 26 weeks was associated with significant improvement in glycemic control irrespective of age, sex, duration of diabetes, body weight, BMI, or concomitant medication.
通过关键人口统计学特征定义的亚组,评估了日本2型糖尿病(T2D)患者每周一次注射0.75mg度拉糖肽的疗效和耐受性。这项事后分析纳入了在三项3期试验(一项开放标签、随机;一项双盲和开放标签、随机;一项开放标签、非随机)中接受0.75mg度拉糖肽治疗长达26周的患者数据。患者根据性别(男性、女性)、年龄(<65岁、≥65岁)、体重(<70kg、≥70kg)、体重指数(BMI;<25kg/m²、≥25kg/m²)、糖尿病病程(<7年、≥7年)、糖化血红蛋白(HbA1c;≤8.5%、>8.5%)、是否同时使用磺脲类药物(是、否)以及是否同时使用双胍类药物(是、否)进行分组。分析的疗效指标包括HbA1c和体重相对于基线的变化以及HbA1c<7.0%的患者百分比。分析的安全性指标包括低血糖和恶心的发生率以及坐位脉搏率相对于基线的变化。总共分析了855名患者。无论患者特征如何,每周一次注射0.75mg度拉糖肽均能改善以HbA1c衡量的血糖控制;与基线值较低的患者相比,基线HbA1c值较高的患者改善更大。基线HbA1c较低的患者和同时服用双胍类药物的患者体重减轻更多。同时使用磺脲类药物对低血糖发生率的影响最大。每周一次注射0.75mg度拉糖肽治疗T2D 26周与血糖控制的显著改善相关,与年龄、性别、糖尿病病程、体重、BMI或同时使用的药物无关。