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利司那肽治疗2型糖尿病患者的临床疗效评估:一项系统文献综述

An Evaluation of the Clinical Therapeutic Effect of Lixisenatide in Type 2 Diabetes Patients: A Systematic Literature Review.

作者信息

Okere Arinze Nkemdirim, Montesdeoca Janele, Glasper April, Diaby Vakaramoko

机构信息

College of Pharmacy and Pharmaceutical Sciences, Florida A&M University, 1415 S Martin Luther King Jr Blvd, Tallahassee, FL 32301, United States.

出版信息

Curr Diabetes Rev. 2018;14(4):363-375. doi: 10.2174/1573399813666170724113240.

Abstract

BACKGROUND

With cardiovascular disease accounting for approximately 50% of deaths in patients diagnosed with type 2 diabetes, it is pertinent to initiate anti-diabetic medications with cardiovascular benefits. This systematic clinical review critically examines the clinical therapeutic effect of lixisenatide.

METHODS

Data were gathered from articles indexed in PubMed, Google Scholar and Medline from 2010 - 2017, with the following search terms, "lixisenatide" and "GLP-1 receptor agonist". Studies written in the English language were included.

RESULTS

Thirteen clinical studies which evaluated the efficacy of lixisenatide were analyzed. Results from these studies showed that lixisenatide is an effective monotherapy in the reduction of glycated hemoglobin (A1C), Postprandial Glucose (PPG) and Fasting Blood Glucose (FPG). As an add-on therapy to metformin or sulfonylureas and insulin, it was found to be clinically effective compared to placebo. In all reviewed trials, there were higher proportions of patients who achieved A1C < 7% or < 6.5% compared to placebo without a corresponding increase in weight. Finally, the use of lixisenatide was not associated with an increased risk of cardiovascular events. The most common adverse events in all lixisenatide groups were nausea, vomiting, and diarrhea.

CONCLUSION

Lixisenatide appears to be safe and effective therapy for the management of type 2 diabetes mellitus. It is not associated with either the risk of cardiovascular events or symptomatic hypoglycemia. Finally, lixisenatide may be best used as an adjunct therapy for patients who are inadequately controlled with other diabetic medications, or select group of patients at risk of insulin induced obesity, hypertension or heart failure.

摘要

背景

心血管疾病占2型糖尿病确诊患者死亡人数的近50%,因此启动具有心血管益处的抗糖尿病药物治疗很有必要。本系统临床综述严格审查了利司那肽的临床治疗效果。

方法

从2010年至2017年在PubMed、谷歌学术和Medline上索引的文章中收集数据,搜索词为“利司那肽”和“GLP-1受体激动剂”。纳入英文撰写的研究。

结果

分析了13项评估利司那肽疗效的临床研究。这些研究结果表明,利司那肽是降低糖化血红蛋白(A1C)、餐后血糖(PPG)和空腹血糖(FPG)的有效单药治疗。作为二甲双胍、磺脲类药物和胰岛素的附加治疗,与安慰剂相比,它在临床上被证明是有效的。在所有综述试验中,与安慰剂相比,实现A1C<7%或<6.5%的患者比例更高,且体重没有相应增加。最后,使用利司那肽与心血管事件风险增加无关。所有利司那肽组中最常见的不良事件是恶心、呕吐和腹泻。

结论

利司那肽似乎是治疗2型糖尿病的安全有效疗法。它与心血管事件风险或症状性低血糖均无关。最后,利司那肽可能最适合作为其他糖尿病药物控制不佳的患者或有胰岛素诱导肥胖、高血压或心力衰竭风险的特定患者群体的辅助治疗。

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