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法西格列净在 2 型糖尿病患者血糖控制中的应用:一项 III 期、安慰剂对照研究。

Fasiglifam for glycaemic control in people with type 2 diabetes: A phase III, placebo-controlled study.

机构信息

Takeda Development Center Americas, Inc., Deerfield, Illinois.

Takeda Development Centre Europe, Ltd., London, UK.

出版信息

Diabetes Obes Metab. 2017 Dec;19(12):1714-1721. doi: 10.1111/dom.13004. Epub 2017 Jul 11.

DOI:10.1111/dom.13004
PMID:28493502
Abstract

AIM

To investigate the effect of fasiglifam on glycaemic control in people with type 2 diabetes mellitus (T2DM).

METHODS

In total, 421 people with T2DM and glycated haemoglobin (HbA1c) ≥7.0% and ≤10.5% who had received only diet and exercise treatment for ≥12 weeks prior to screening were randomized to receive fasiglifam 25 or 50 mg or placebo. The primary efficacy endpoint was change from baseline in HbA1c at week 24.

RESULTS

The mean participant age was 53.5 years, mean baseline body mass index 32.3 kg/m , and mean baseline HbA1c level 8.05%. Least squares mean changes in HbA1c from baseline to week 24 were: -0.93% (fasiglifam 50 mg), -0.65% (fasiglifam 25 mg) and -0.17% (placebo). Treatment-emergent adverse events (TEAEs) occurred in 53.3%, 48.2% and 39.9% of participants receiving fasiglifam 25 mg, fasiglifam 50 mg, and placebo, respectively. Three participants in each group experienced a serious adverse event (AE). Nine participants had alanine aminotransferase (ALT) elevations >3× upper limit of normal: 5 (3.6%) in the fasiglifam 25-mg group, 4 (2.8%) in the fasiglifam 50-mg group, and none in the placebo group.

CONCLUSIONS

The data indicate that fasiglifam effectively reduced HbA1c from baseline for 24 weeks in participants with T2DM. The incidence of TEAEs was higher in the fasiglifam groups; however, the incidence of serious AEs was low overall and similar between groups. ALT elevations were observed only in the fasiglifam groups, which contributed to the decision to terminate the fasiglifam programme after completion of the present study.

摘要

目的

研究法格列汀对 2 型糖尿病(T2DM)患者血糖控制的影响。

方法

共有 421 名 T2DM 患者,糖化血红蛋白(HbA1c)≥7.0%且≤10.5%,在筛选前已接受至少 12 周的饮食和运动治疗,将其随机分为接受法格列汀 25 或 50mg 或安慰剂治疗。主要疗效终点为 24 周时与基线相比 HbA1c 的变化。

结果

参与者的平均年龄为 53.5 岁,平均基线体重指数为 32.3kg/m ,平均基线 HbA1c 水平为 8.05%。从基线到 24 周时,HbA1c 的最小二乘均值变化为:-0.93%(法格列汀 50mg)、-0.65%(法格列汀 25mg)和-0.17%(安慰剂)。接受法格列汀 25mg、法格列汀 50mg 和安慰剂的参与者中分别有 53.3%、48.2%和 39.9%发生治疗中出现的不良事件(TEAEs)。每组各有 3 名参与者发生严重不良事件(AE)。9 名参与者的丙氨酸氨基转移酶(ALT)升高>3×正常值上限:法格列汀 25mg 组 5 例(3.6%)、法格列汀 50mg 组 4 例(2.8%)、安慰剂组无 1 例。

结论

数据表明,法格列汀可有效降低 T2DM 患者的 HbA1c,从基线到 24 周。法格列汀组的 TEAEs 发生率较高;然而,严重 AE 的总发生率较低且组间相似。仅在法格列汀组观察到 ALT 升高,这导致在完成本研究后决定终止法格列汀项目。

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