Webb Neil, Orme Michelle, Witkowski Michal, Nakanishi Rie, Langer Jakob
DRG Abacus, Bicester, Oxfordshire, UK.
ICERA Consulting Ltd., Swindon, UK.
Diabetes Ther. 2018 Jun;9(3):973-986. doi: 10.1007/s13300-018-0397-1. Epub 2018 Mar 24.
Semaglutide once-weekly (QW) is a novel glucagon-like peptide-1 (GLP-1) analogue administered at a 0.5 or 1.0 mg dose. In the absence of head-to-head trials between semaglutide QW and other GLP-1 receptor agonists (GLP-1 RAs) in a Japanese population, a network meta-analysis (NMA) was performed. The objective was to assess the relative efficacy and safety of semaglutide QW vs GLP-1 RAs in Japanese patients with type 2 diabetes (T2DM), with a specific focus on the comparison between semaglutide 0.5 mg QW and dulaglutide 0.75 mg QW.
A systematic review (SR) and supplementary Japanese searches were conducted to identify trials of GLP-1 RAs in Japanese patients on diet and exercise, who have previously received 0-1 oral antidiabetic drugs (OADs). Data at 52-56 weeks were extracted for the following outcomes (feasible for analysis in an NMA): glycated hemoglobin (HbA), fasting plasma glucose (FPG), weight, systolic blood pressure (SBP), and overall hypoglycemia. The data were synthesized using an NMA and a Bayesian framework.
Four trials, identified from the SR and Japanese-specific searches, were relevant for inclusion in the NMA. When compared to dulaglutide 0.75 mg QW, semaglutide 0.5 mg QW was shown to provide significant reductions in HbA [- 0.61% (12.3 mmol/mol)], weight (- 1.45 kg), SBP (- 5.03 mmHg), and FPG (- 1.26 mmol/L). No significant differences in the proportion of patients achieving a HbA level < 7% (53 mmol/mol) or the risk of overall hypoglycemia were observed between semaglutide 0.5 mg QW and dulaglutide 0.75 mg QW.
Overall, semaglutide 0.5 mg QW was associated with significant reductions from baseline in HbA, weight, SBP, and FPG compared with dulaglutide 0.75 mg QW in Japanese patients with T2DM. These data may provide valuable evidence for clinical decision-making, cost-effectiveness analyses, and health technology appraisal (HTA) requirements.
Novo Nordisk Pharma Ltd.
司美格鲁肽每周一次（QW）是一种新型胰高血糖素样肽-1（GLP-1）类似物，给药剂量为0.5或1.0毫克。在日本人群中，司美格鲁肽QW与其他GLP-1受体激动剂（GLP-1 RAs）之间缺乏头对头试验的情况下，进行了一项网状Meta分析（NMA）。目的是评估司美格鲁肽QW与GLP-1 RAs在日本2型糖尿病（T2DM）患者中的相对疗效和安全性，特别关注司美格鲁肽0.5毫克QW与度拉糖肽0.75毫克QW之间的比较。
进行了一项系统评价（SR）和补充的日语检索，以确定在饮食和运动基础上、之前接受过0-1种口服抗糖尿病药物（OADs）的日本患者中GLP-1 RAs的试验。提取了52-56周时以下结局的数据（可用于NMA分析）：糖化血红蛋白（HbA）、空腹血糖（FPG）、体重、收缩压（SBP）和总体低血糖情况。使用NMA和贝叶斯框架对数据进行综合分析。
从SR和日语特定检索中确定的四项试验与纳入NMA相关。与度拉糖肽0.75毫克QW相比，司美格鲁肽0.5毫克QW显示出糖化血红蛋白显著降低[-0.61%（12.3 mmol/mol）]、体重降低（-1.45千克）、收缩压降低（-5.03 mmHg）和空腹血糖降低（-1.26 mmol/L）。在司美格鲁肽0.5毫克QW和度拉糖肽0.75毫克QW之间，未观察到糖化血红蛋白水平<7%（53 mmol/mol）的患者比例或总体低血糖风险有显著差异。
总体而言，在日本T2DM患者中，与度拉糖肽0.75毫克QW相比，司美格鲁肽0.5毫克QW与糖化血红蛋白、体重、收缩压和空腹血糖较基线水平显著降低相关。这些数据可为临床决策、成本效益分析和卫生技术评估（HTA）要求提供有价值的证据。
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