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利拉鲁肽用于青少年肥胖人群:一项随机、双盲、安慰剂对照的5周试验,以评估利拉鲁肽在12至17岁青少年中的安全性、耐受性和药代动力学。

Liraglutide in an Adolescent Population with Obesity: A Randomized, Double-Blind, Placebo-Controlled 5-Week Trial to Assess Safety, Tolerability, and Pharmacokinetics of Liraglutide in Adolescents Aged 12-17 Years.

作者信息

Danne Thomas, Biester Torben, Kapitzke Kerstin, Jacobsen Sanja H, Jacobsen Lisbeth V, Petri Kristin C Carlsson, Hale Paula M, Kordonouri Olga

机构信息

Diabetes Centre for Children and Adolescents, Children's Hospital auf der Bult, Hannover, Germany.

Diabetes Centre for Children and Adolescents, Children's Hospital auf der Bult, Hannover, Germany.

出版信息

J Pediatr. 2017 Feb;181:146-153.e3. doi: 10.1016/j.jpeds.2016.10.076. Epub 2016 Dec 13.

Abstract

OBJECTIVES

To investigate the safety, tolerability, and pharmacokinetics of liraglutide in adolescents with obesity.

STUDY DESIGN

This was a randomized, double-blind, placebo-controlled trial. Twenty-one subjects, aged 12-17 years and Tanner stage 2-5, with obesity (body mass index [BMI] corresponding to both a BMI ≥95th percentile for age and sex and to a BMI of ≥30 kg/m for adults; additionally, BMI was ≤45 kg/m) were randomized (2:1) to receive 5 weeks of treatment with liraglutide (0.6 mg with weekly dose increase to a maximum of 3.0 mg for the last week) (n = 14) or placebo (n = 7). The primary endpoint was number of treatment-emergent adverse events (TEAEs). Secondary endpoints included safety measures, and pharmacokinetic and pharmacodynamic endpoints.

RESULTS

All participants receiving liraglutide, and 4 receiving placebo (57.1%), had at least 1 TEAE. The most common TEAEs were gastrointestinal disorders. No severe TEAEs, TEAE-related withdrawals, or deaths occurred. Twelve hypoglycemic episodes occurred in 8 participants receiving liraglutide and 2 in 1 participant receiving placebo. No severe hypoglycemic episodes were reported. Liraglutide exposure in terms of trough concentration increased with dose, although dose proportionality was confounded by unexpectedly low trough concentration values at the 2.4 mg dose. Exposure in terms of model-derived area under the plasma concentration time curve from 0 to 24 hours after dose in steady state was similar to that in adults with obesity.

CONCLUSIONS

Liraglutide had a similar safety and tolerability profile compared with adults when administered to adolescents with obesity, with no unexpected safety/tolerability issues. Results suggest that the dosing regimen approved for weight management in adults may be appropriate for use in adolescents.

TRIAL REGISTRATION

ClinicalTrials.gov: NCT01789086.

摘要

目的

研究利拉鲁肽在肥胖青少年中的安全性、耐受性和药代动力学。

研究设计

这是一项随机、双盲、安慰剂对照试验。21名年龄在12至17岁、坦纳分期为2至5期的肥胖受试者(体重指数[BMI]对应于年龄和性别的BMI≥第95百分位数以及成人BMI≥30 kg/m²;此外,BMI≤45 kg/m²)被随机分组(2:1),接受为期5周的利拉鲁肽治疗(0.6 mg,每周剂量增加,最后一周最高剂量为3.0 mg)(n = 14)或安慰剂(n = 7)。主要终点是治疗中出现的不良事件(TEAE)数量。次要终点包括安全指标以及药代动力学和药效学终点。

结果

所有接受利拉鲁肽治疗的参与者以及4名接受安慰剂治疗的参与者(57.1%)至少出现1次TEAE。最常见的TEAE是胃肠道疾病。未发生严重TEAE、与TEAE相关的停药或死亡。8名接受利拉鲁肽治疗的参与者发生了12次低血糖事件,1名接受安慰剂治疗的参与者发生了2次低血糖事件。未报告严重低血糖事件。就谷浓度而言,利拉鲁肽的暴露量随剂量增加,尽管在2.4 mg剂量时谷浓度值意外偏低,使剂量比例关系受到干扰。稳态下给药后0至24小时血浆浓度时间曲线下基于模型推导的面积所反映的暴露量与肥胖成人相似。

结论

在肥胖青少年中给药时,利拉鲁肽与成人相比具有相似的安全性和耐受性特征,没有意外的安全/耐受性问题。结果表明,批准用于成人体重管理的给药方案可能适用于青少年。

试验注册

ClinicalTrials.gov:NCT01789086。

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