Takatsuki Red Cross Hospital, Osaka, Japan.
Novo Nordisk Pharma Ltd., Tokyo, Japan.
J Diabetes Investig. 2018 Jul;9(4):840-849. doi: 10.1111/jdi.12793. Epub 2018 Feb 5.
AIMS/INTRODUCTION: To determine the efficacy and safety of adding liraglutide to three different insulin regimens in Japanese patients with type 2 diabetes mellitus.
In this post-hoc analysis, results from a 36-week, randomized, double-blind, placebo-controlled, parallel-group trial are reported. Individuals with type 2 diabetes mellitus were stratified according to their pre-trial insulin regimen (basal, basal-bolus and premix). The primary objective was to determine whether adding liraglutide (0.9 mg/day) to fixed-dose insulin therapy was superior vs fixed-dose insulin monotherapy, assessed by the effect on glycemic control after 16 weeks of treatment.
The treatment effect on glycated hemoglobin reduction was independent of the pre-trial insulin regimen. Comparing liraglutide with a placebo, liraglutide was associated with glycated hemoglobin reduction in all insulin regimens, with placebo-corrected reductions at 16 weeks ranging from -1.45 to -1.17%, and maintained at 36 weeks. Liraglutide resulted in a greater reduction in mean plasma glucose obtained from seven-point self-monitoring, and greater proportions of patients achieved target glycated hemoglobin. With liraglutide, slightly higher proportions of patients receiving basal and basal-bolus insulin reported confirmed hypoglycemia from 0 to 16 weeks.
The efficacy and safety of adding liraglutide to insulin therapy was confirmed, regardless of pre-trial insulin regimen.
目的/引言:旨在确定在日本 2 型糖尿病患者中,将利拉鲁肽添加到三种不同胰岛素方案中的疗效和安全性。
在这项事后分析中,报告了一项 36 周、随机、双盲、安慰剂对照、平行组试验的结果。根据其试验前胰岛素方案(基础、基础-餐时和预混)对 2 型糖尿病患者进行分层。主要目的是确定将利拉鲁肽(0.9mg/天)添加到固定剂量胰岛素治疗是否优于固定剂量胰岛素单药治疗,通过治疗 16 周后对血糖控制的影响来评估。
降糖作用不受试验前胰岛素方案的影响。与安慰剂相比,在所有胰岛素方案中,利拉鲁肽均与糖化血红蛋白降低相关,安慰剂校正的 16 周降幅为-1.45%至-1.17%,并维持至 36 周。利拉鲁肽使七点自我监测的平均血浆葡萄糖降低更大,更多的患者达到了糖化血红蛋白目标。在接受利拉鲁肽治疗的患者中,接受基础和基础-餐时胰岛素治疗的患者中,有略高比例的患者在 0 至 16 周报告了确诊的低血糖。
无论试验前胰岛素方案如何,添加利拉鲁肽至胰岛素治疗的疗效和安全性均得到证实。