Umpierrez G E, Pantalone K M, Kwan A Y M, Zimmermann A G, Zhang N, Fernández Landó L
Division of Endocrinology, Emory University School of Medicine, Atlanta, GA, USA.
Department of Endocrinology, Cleveland Clinic, Cleveland, OH, USA.
Diabetes Obes Metab. 2016 Jun;18(6):615-22. doi: 10.1111/dom.12660. Epub 2016 Apr 13.
To assess the relationship between weight change and glycated haemoglobin (HbA1c) change in dulaglutide-treated patients by analysing data from six head-to-head phase III AWARD clinical trials.
At 26 weeks, the relationship between weight and HbA1c was analysed in each trial rather than by pooling data because of differences in design and background therapy. The effect of baseline characteristics was also evaluated with regard to weight and HbA1c response.
Across the studies, 87-97% and 83-95% of patients treated with dulaglutide 1.5 and 0.75 mg, respectively, had reductions in HbA1c levels, while 57-88% and 43-84% of patients treated with dulaglutide 1.5 and 0.75 mg, respectively, experienced weight loss. The majority (55-83%) of patients receiving dulaglutide 1.5 mg experienced weight loss and HbA1c reductions, while 41-79% of patients in the dulaglutide 0.75 mg arm lost weight and had reductions in HbA1c level. A weak and inconsistent correlation was observed between the changes in weight and HbA1c (range from -0.223 to 0.267) in patients treated with dulaglutide. The baseline characteristics of gender, age, duration of diabetes, HbA1c, body weight and BMI were not related to different combinations of weight and HbA1c responses.
Dulaglutide is an effective treatment option across the type 2 diabetes treatment spectrum. Dulaglutide showed dose-dependent effects on both weight loss and HbA1c reduction. These effects had a weak correlation and appeared to be independent.
通过分析六项头对头III期AWARD临床试验的数据,评估度拉糖肽治疗患者体重变化与糖化血红蛋白(HbA1c)变化之间的关系。
由于设计和背景治疗的差异,在每项试验中于26周时分析体重与HbA1c之间的关系,而非汇总数据。还评估了基线特征对体重和HbA1c反应的影响。
在各项研究中,分别接受1.5 mg和0.75 mg度拉糖肽治疗的患者中,有87%-97%和83%-95%的患者HbA1c水平降低,而分别接受1.5 mg和0.75 mg度拉糖肽治疗的患者中,有57%-88%和43%-84%的患者体重减轻。接受1.5 mg度拉糖肽治疗的大多数患者(55%-83%)体重减轻且HbA1c降低,而度拉糖肽0.75 mg组中有41%-79%的患者体重减轻且HbA1c水平降低。在接受度拉糖肽治疗的患者中,体重变化与HbA1c变化之间观察到弱且不一致的相关性(范围为-0.223至0.267)。性别、年龄、糖尿病病程、HbA1c、体重和BMI的基线特征与体重和HbA1c反应的不同组合无关。
度拉糖肽是2型糖尿病治疗全谱中的一种有效治疗选择。度拉糖肽对体重减轻和HbA1c降低均显示出剂量依赖性效应。这些效应相关性较弱且似乎相互独立。