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阿格列汀治疗2型糖尿病的疗效与安全性:中国大陆一项多中心、随机、双盲、安慰剂对照的III期临床试验

[Efficacy and safety of alogliptin in treatment of type 2 diabetes mellitus: a multicenter, randomized, double-blind, placebo-controlled phase III clinical trial in mainland China].

作者信息

Pan Changyu, Li Wenhui, Zeng Jiaoe, Li Chengjiang, Yang Jinkui, Ji Qiuhe, Lu Juming, Lyu Xiaofeng, Li Xuefeng, Qu Shen, Xu Xiangjin, Xue Yaoming, Li Ling, Jiang Zhaoshun, Zheng Baozhong, Bu Ruifang, Han Ping, Liu Yu, Liu Jingdong, Peng Yongde, Liu Xiaomin, Liu Zhimin, Yan Li, Lei Minxiang, Li Xuejun, Song Qinhua, Shi Bingyin, Gu Wei, Li Zhengfang

机构信息

Department of Endocrinology, Chinese PLA General Hospital, Beijing 100853, China; Email:

出版信息

Zhonghua Nei Ke Za Zhi. 2015 Nov;54(11):949-53.

Abstract

OBJECTIVE

To evaluate the efficacy and safety of alogliptin in Chinese patients with type 2 diabetes (T2DM).

METHODS

This was a multicenter, randomized, double-blind, placebo-controlled phase III trial. A total of 491 subjects with T2DM were randomized in a 1:1 ratio to receive alogliptin (25 mg once daily) or placebo for 16 weeks. Among them, 181 were in the monotherapy group (group A), 186 were in the add-on to metformin group (group B), and 124 were in the add-on to pioglitazone group (group C).

RESULTS

After 16 weeks of therapy, glycosylated hemoglobin A1c (HbA1c) levels decreased in both alogliptin and placebo groups. The mean changes in HbA1c for alogliptin and placebo were 1.00% and 0.43% (P<0.001), 0.91% and 0.23% (P<0.001), and 0.76% and 0.25% (P<0.001) in group A, B and C, respectively. Compared with placebo, alogliptin treatment led to a greater decrease in fasting plasma glucose (FPG) and a higher percentage of subjects who achieved HbA1c targets of ≤ 6.5% and ≤ 7.0%. The percentage of subjects who experienced all adverse events including hypoglycemia with alogliptin were comparable to those with placebo.

CONCLUSIONS

Alogliptin 25 mg once daily reduced HbA1c and FPG, and increased a greater proportion of subjects achieving HbA1c goals of ≤6.5% and ≤7.0% compared with placebo when used as a monotherapy, add-on to metformin, or add-on to pioglitazone. The hypoglycemia rates and safety profiles with alogliptin were similar to those with placebo.

摘要

目的

评估阿格列汀在中国2型糖尿病(T2DM)患者中的疗效和安全性。

方法

这是一项多中心、随机、双盲、安慰剂对照的III期试验。总共491例T2DM患者按1:1比例随机分组,接受阿格列汀(每日一次,25毫克)或安慰剂治疗16周。其中,181例在单药治疗组(A组),186例在联合二甲双胍治疗组(B组),124例在联合吡格列酮治疗组(C组)。

结果

治疗16周后,阿格列汀组和安慰剂组的糖化血红蛋白A1c(HbA1c)水平均有所下降。A组、B组和C组阿格列汀组和安慰剂组HbA1c的平均变化分别为1.00%和0.43%(P<0.001)、0.91%和0.23%(P<0.001)以及0.76%和0.25%(P<0.001)。与安慰剂相比,阿格列汀治疗导致空腹血糖(FPG)更大幅度下降,且达到HbA1c目标值≤6.5%和≤7.0%的受试者比例更高。阿格列汀组经历包括低血糖在内的所有不良事件的受试者百分比与安慰剂组相当。

结论

与安慰剂相比,每日一次25毫克阿格列汀作为单药治疗、联合二甲双胍或联合吡格列酮使用时,可降低HbA1c和FPG,并使更多受试者达到HbA1c目标值≤6.5%和≤7.0%。阿格列汀的低血糖发生率和安全性与安慰剂相似。

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