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卡格列净在生活于炎热气候地区的2型糖尿病患者中的疗效与安全性。

Efficacy and safety of canagliflozin in patients with type 2 diabetes mellitus living in hot climates.

作者信息

John Mathew, Cerdas Sonia, Violante Rafael, Deerochanawong Chaicharn, Hassanein Mohamed, Slee April, Canovatchel William, Hamilton Gill

机构信息

Providence Endocrine & Diabetes Specialty Centre, Trivandrum, Kerala, India.

Hospital Cima, Centro de Investigacíon Clínica San Agustín, San José, Costa Rica.

出版信息

Int J Clin Pract. 2016 Sep;70(9):775-85. doi: 10.1111/ijcp.12868.

Abstract

AIMS

Patients with type 2 diabetes mellitus (T2DM) have increased risk of adverse events (AEs; e.g. dehydration, hypoglycaemia) in hot weather. This analysis assessed the efficacy and safety of canagliflozin, a sodium glucose co-transporter 2 (SGLT2) inhibitor, in patients with T2DM who live in hot climates.

METHODS

This post hoc analysis evaluated patients with T2DM using pooled data from four 26-week, placebo-controlled studies (N=2,313) and data from a 104-week, active-controlled study (add-on to metformin vs glimepiride; N=1,450). Changes in HbA1c, fasting plasma glucose (FPG), body weight and blood pressure (BP) were assessed in subsets of patients living in hot climates (pooled, placebo-controlled studies, n=611; active-controlled study, n=307) and those living in other climates (i.e. other climate subset; pooled, placebo-controlled studies, n=1,702; active-controlled study, n=1,143). Safety was assessed based on AE reports.

RESULTS

Canagliflozin 100 and 300 mg lowered HbA1c, FPG, body weight and BP vs placebo over 26 weeks and glimepiride over 104 weeks in the hot climate subsets. Canagliflozin was generally well tolerated in the hot climate subsets, with a higher incidence of AEs related to the mechanism of SGLT2 inhibition (i.e. genital mycotic infections). Volume depletion-related AEs were low across groups.

CONCLUSION

Canagliflozin improved glycaemic control, lowered body weight and BP, and was generally well tolerated in patients with T2DM living in hot climates compared with placebo over 26 weeks or glimepiride over 104 weeks.

CLINICAL TRIALS REGISTRATION

ClinicalTrials.gov NCT01081834, NCT01106677, NCT01106625, NCT01106690, NCT00968812.

摘要

目的

2型糖尿病(T2DM)患者在炎热天气下发生不良事件(如脱水、低血糖)的风险增加。本分析评估了钠-葡萄糖协同转运蛋白2(SGLT2)抑制剂卡格列净在生活于炎热气候地区的T2DM患者中的疗效和安全性。

方法

本事后分析使用来自四项为期26周的安慰剂对照研究(N = 2313)的汇总数据以及一项为期104周的活性药物对照研究(二甲双胍与格列美脲联用;N = 1450)的数据,对T2DM患者进行评估。在生活于炎热气候地区的患者亚组(汇总的安慰剂对照研究,n = 611;活性药物对照研究,n = 307)和生活于其他气候地区的患者(即其他气候亚组;汇总的安慰剂对照研究,n = 1702;活性药物对照研究,n = 1143)中,评估糖化血红蛋白(HbA1c)、空腹血糖(FPG)、体重和血压(BP)的变化。根据不良事件报告评估安全性。

结果

在炎热气候亚组中,与安慰剂相比,卡格列净100和300mg在26周内降低了HbA1c、FPG、体重和血压,与格列美脲相比,在104周内降低了这些指标。在炎热气候亚组中,卡格列净总体耐受性良好,与SGLT2抑制机制相关的不良事件(即生殖器真菌感染)发生率较高。各治疗组中与容量耗竭相关的不良事件发生率较低。

结论

与安慰剂相比,卡格列净在26周内或与格列美脲相比在104周内改善了生活于炎热气候地区的T2DM患者的血糖控制,降低了体重和血压,总体耐受性良好。

临床试验注册

ClinicalTrials.gov NCT01081834、NCT01106677、NCT01106625、NCT01106690、NCT00968812。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5144/5129493/c3f5f42e492a/IJCP-70-775-g001.jpg

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