Mita Tomoya, Katakami Naoto, Shiraiwa Toshihiko, Yoshii Hidenori, Gosho Masahiko, Ishii Hitoshi, Shimomura Iichiro, Watada Hirotaka
Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan.
Department of Metabolic Medicine, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan.
Diabetes Ther. 2017 Jun;8(3):693-704. doi: 10.1007/s13300-017-0267-2. Epub 2017 May 17.
Treatment-related quality of life (QOL) is an important aspect of diabetes management. Here, we investigated the influence of sitagliptin, a dipeptidyl peptidase-4 inhibitor, on treatment-related QOL in patients with type 2 diabetes mellitus treated with insulin.
This was a prespecified sub-analysis of the Sitagliptin Preventive Study of Intima-Media Thickness Evaluation (SPIKE). The study population consisted of 71 subjects in the sitagliptin group, and 62 subjects in the conventional group who were treated with insulin. Patients of the sitagliptin group were started on sitagliptin in addition to ongoing insulin therapy. In the conventional group, either increasing the dose of current insulin therapy or the addition of oral hypoglycemic agents other than dipeptidyl peptidase-4 inhibitors was allowed to achieve glycemic control. Treatment-related QOL was evaluated before and 104 weeks after the initiation of the study using the Diabetes Therapy-Related QOL Questionnaire 7 (DTR-QOL7).
Forty-five out of 71 subjects in the sitagliptin group and 41 out of 62 subjects in the conventional group filled out the QOL questionnaire at week 104. The DTR-QOL7 score at week 104 was significantly increased from baseline in the sitagliptin group, while that in the conventional group was not changed. However, the changes in score did not differ between the two groups. Change in HbA1c was negatively associated with change in score.
Our data suggest that sitagliptin added to insulin treatment was comparable to other treatments in terms of its impact on treatment-related QOL.
ClinicalTrials.gov identifier: UMIN000007396.
Mitsubishi Tanabe Pharma Co., Ono Pharmaceutical Co., and Novo Nordisk.
治疗相关的生活质量(QOL)是糖尿病管理的一个重要方面。在此,我们研究了二肽基肽酶-4抑制剂西他列汀对接受胰岛素治疗的2型糖尿病患者治疗相关生活质量的影响。
这是西他列汀内膜中层厚度评估预防研究(SPIKE)的一项预先设定的亚分析。研究人群包括西他列汀组的71名受试者和接受胰岛素治疗的常规组的62名受试者。西他列汀组的患者在继续胰岛素治疗的基础上开始使用西他列汀。在常规组中,允许增加当前胰岛素治疗的剂量或添加除二肽基肽酶-4抑制剂以外的口服降糖药以实现血糖控制。使用糖尿病治疗相关生活质量问卷7(DTR-QOL7)在研究开始前和开始后104周评估治疗相关生活质量。
西他列汀组71名受试者中的45名和常规组62名受试者中的41名在第104周填写了生活质量问卷。西他列汀组第104周的DTR-QOL7评分较基线显著增加,而常规组未改变。然而,两组评分的变化没有差异。糖化血红蛋白(HbA1c)的变化与评分的变化呈负相关。
我们的数据表明,在胰岛素治疗中添加西他列汀在对治疗相关生活质量的影响方面与其他治疗相当。
ClinicalTrials.gov标识符:UMIN000007396。
三菱田边制药公司、小野制药公司和诺和诺德公司。