LMC Diabetes and Endocrinology, East York, Canada.
National Research Institute, Los Angeles, California.
Diabetes Obes Metab. 2018 Jun;20(6):1453-1460. doi: 10.1111/dom.13251. Epub 2018 Feb 23.
This phase III, multicentre, randomized study (ClinicalTrials.gov; NCT01958671) evaluated the efficacy and safety of ertugliflozin monotherapy in adults with inadequately controlled type 2 diabetes (glycated haemoglobin [HbA1c], 7.0% to 10.5% [53-91 mmol/mol]) despite diet and exercise.
The 52-week study comprised a 26-week, double-blind, placebo-controlled period (Phase A) during which 461 participants received placebo, ertugliflozin 5 mg/d or ertugliflozin 15 mg/d. This was followed by a 26-week active-controlled period (Phase B) during which participants in the placebo group who had not received glycaemic rescue therapy had blinded metformin added. Results to Week 52 are reported. Because of the use of metformin in Phase B, no statistical comparisons of efficacy were made between the ertugliflozin and placebo/metformin groups at Week 52.
The mean (standard error) change from baseline to Week 52 in HbA1c was -0.9% (0.1) and -1.0% (0.1) in the ertugliflozin 5 and 15 mg groups, respectively. The proportions of participants with HbA1c <7.0% at Week 52 were 25.6% and 28.5%, respectively. Ertugliflozin reduced fasting plasma glucose, body weight and systolic blood pressure (SBP). The incidence of genital mycotic infections (GMIs) in females was significantly higher in both ertugliflozin groups (5 mg, 26.9%; 15 mg, 29.0%) vs the placebo/metformin group (9.9%), and in males was significantly higher in the 15 mg group (7.8%) vs the placebo/metformin group (1.2%). Ertugliflozin was not associated with increased incidence of urinary tract infections, symptomatic hypoglycaemia or hypovolaemia adverse events compared with placebo/metformin.
Ertugliflozin treatment over 52 weeks improved glycaemic control and reduced body weight and SBP, but increased GMIs.
这项 III 期、多中心、随机研究(ClinicalTrials.gov;NCT01958671)评估了在饮食和运动控制下,对于糖化血红蛋白(HbA1c)为 7.0%至 10.5%(53-91mmol/mol)的 2 型糖尿病患者,厄格列净单药治疗的疗效和安全性。
这项 52 周的研究包括 26 周的双盲、安慰剂对照期(A 期),461 名参与者接受安慰剂、厄格列净 5mg/d 或 15mg/d。之后是 26 周的活性对照期(B 期),安慰剂组中未接受血糖控制治疗的患者加用二甲双胍。报告截至 52 周的结果。由于 B 期使用了二甲双胍,因此在第 52 周时,厄格列净组与安慰剂/二甲双胍组之间没有进行疗效的统计学比较。
与基线相比,厄格列净 5mg 和 15mg 组的 HbA1c 在第 52 周时的平均(标准误差)变化分别为-0.9%(0.1)和-1.0%(0.1)。第 52 周时 HbA1c<7.0%的参与者比例分别为 25.6%和 28.5%。厄格列净降低空腹血浆葡萄糖、体重和收缩压(SBP)。女性中,厄格列净组(5mg 组为 26.9%,15mg 组为 29.0%)的生殖器真菌感染(GMIs)发生率显著高于安慰剂/二甲双胍组(9.9%),而男性中 15mg 组(7.8%)的发生率显著高于安慰剂/二甲双胍组(1.2%)。与安慰剂/二甲双胍相比,厄格列净治疗未增加尿路感染、症状性低血糖或低血容量不良事件的发生率。
厄格列净治疗 52 周可改善血糖控制,并降低体重和 SBP,但会增加 GMIs。