Oita Mayuko, Miyoshi Hideaki, Ono Kota, Nakamura Akinobu, Cho Kyu Yong, Nomoto Hiroshi, Yamamoto Kohei, Omori Kazuno, Manda Naoki, Kurihara Yoshio, Aoki Shin, Atsumi Tatsuya
Division of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University Hospital, North 15, West 7, Kita-ku, Sapporo 060-8638, Japan.
Clinical Research and Medical Innovation Center, Hokkaido University Hospital, North 15, West 7, Kita-ku, Sapporo 060-8638, Japan.
Endocr J. 2018 Feb 26;65(2):141-150. doi: 10.1507/endocrj.EJ17-0303. Epub 2017 Oct 31.
We compared treatment satisfaction between daily dipeptidyl peptidase-4 (DPP-4) inhibitors and a weekly DPP-4 inhibitor in patients with type 2 diabetes. The study was a 12-week, open-label, randomized, multicenter, controlled trial. Participants were Japanese patients with type 2 diabetes who had received daily DPP-4 inhibitors for more than 3 months. Patients were randomly assigned to a treatment cohort: (1) a group that continued taking daily DPP-4 inhibitors (daily group); or (2) a group that switched from daily DPP-4 inhibitors to a weekly DPP-4 inhibitor, trelagliptin (weekly group). The primary outcome was the change in treatment satisfaction levels from baseline to 12 weeks between the two groups, according to Diabetes Treatment Satisfaction Questionnaire (DTSQ) and Diabetes Therapy-Related Quality of Life (DTR-QOL) questionnaire scores. The changes in glycemic control and body weight were also assessed. Of 49 patients initially enrolled in the study, 47 completed the study. The change in DTSQ scores in the weekly group was not significantly different from that in the daily group. However, the improvements in total score and subscale domains 1 and 2 in the DTR-QOL analysis, which relate to burden on social/daily activities and anxiety/dissatisfaction with treatment, were significantly greater in the weekly group than the daily group (p = 0.048, 0.013 and 0.045, respectively). Mean changes in glycated hemoglobin levels and body weight were comparable between the groups. Switching from daily DPP-4 inhibitors to a weekly DPP-4 inhibitor, trelagliptin, could partially improve treatment satisfaction levels in patients with type 2 diabetes without affecting glycemic control.
我们比较了每日服用二肽基肽酶-4（DPP-4）抑制剂与每周服用一次DPP-4抑制剂在2型糖尿病患者中的治疗满意度。该研究为一项为期12周的开放标签、随机、多中心对照试验。参与者为日本2型糖尿病患者，他们已接受每日DPP-4抑制剂治疗超过3个月。患者被随机分配到一个治疗队列中：（1）继续服用每日DPP-4抑制剂的组（每日组）；或（2）从每日DPP-4抑制剂转换为每周一次DPP-4抑制剂曲格列汀的组（每周组）。主要结局是根据糖尿病治疗满意度问卷（DTSQ）和糖尿病治疗相关生活质量（DTR-QOL）问卷评分，两组从基线到12周治疗满意度水平的变化。还评估了血糖控制和体重的变化。最初纳入研究的49例患者中，47例完成了研究。每周组的DTSQ评分变化与每日组无显著差异。然而，在DTR-QOL分析中，与社交/日常活动负担以及对治疗的焦虑/不满相关的总分及子量表领域1和2的改善，每周组显著大于每日组（p分别为0.048、0.013和0.045）。两组糖化血红蛋白水平和体重的平均变化相当。从每日DPP-4抑制剂转换为每周一次的DPP-4抑制剂曲格列汀，可部分提高2型糖尿病患者的治疗满意度，且不影响血糖控制。
