Division of Endocrinology, Diabetes & Metabolic Diseases, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania.
National Research Institute, Los Angeles, California.
Diabetes Obes Metab. 2018 Jun;20(6):1515-1519. doi: 10.1111/dom.13206. Epub 2018 Feb 4.
This post hoc analysis assessed the effects on cardiovascular risk factors of body weight, systolic blood pressure (SBP) and triglycerides after 28 weeks' treatment with exenatide once weekly plus dapagliflozin, as compared with exenatide once weekly or dapagliflozin, in patient subpopulations from the DURATION-8 trial of patients with type 2 diabetes mellitus (T2DM) inadequately controlled with metformin alone. Subgroups of patients were stratified according to their baseline body weight, SBP and triglyceride levels. Body weight, SBP and triglyceride levels were reduced across most respective subgroups, with no significant subgroup-by-treatment interactions. For each treatment, weight loss was numerically greater as baseline body mass index increased. SBP reductions were greater among patients with SBP ≥140 vs <140 mm Hg for exenatide once weekly plus dapagliflozin and exenatide once weekly. Reductions in triglyceride levels were greater among patients with baseline triglycerides <1.69 vs ≥1.69 mmol/L for each treatment. The combination of exenatide once weekly plus dapagliflozin reduced cardiovascular risk factors across baseline subgroups for each variable to a greater extent than did either individual drug; the greatest effects were observed in the high baseline subgroups for body weight and SBP.
本事后分析评估了 28 周艾塞那肽每周一次联合达格列净与艾塞那肽每周一次或达格列净治疗对二甲双胍单药控制不佳的 2 型糖尿病（T2DM）患者 DURATION-8 试验中患者体重、收缩压（SBP）和甘油三酯心血管风险因素的影响。根据患者的基线体重、SBP 和甘油三酯水平对患者亚组进行分层。大多数相应亚组的体重、SBP 和甘油三酯水平均降低，且无显著的治疗-亚组交互作用。对于每种治疗，体重减轻随基线体重指数的增加而呈数值增加。与艾塞那肽每周一次相比，艾塞那肽每周一次联合达格列净治疗 SBP≥140mmHg 的患者 SBP 降低更大；SBP<140mmHg 的患者 SBP 降低更大。与基线甘油三酯≥1.69mmol/L 相比，每种治疗的患者基线甘油三酯<1.69mmol/L 时甘油三酯水平降低更大。与每种药物相比，每周一次联合艾塞那肽加达格列净治疗可更显著降低各变量的心血管风险因素，在体重和 SBP 的高基线亚组中观察到最大的效果。
