2 型糖尿病患者参与 LEADER 试验的健康相关生活质量。

Health-related quality of life in people with type 2 diabetes participating in the LEADER trial.

机构信息

Diabetes Centre Bochum-Hattingen, Medical Department I, St. Josef-Hospital, Ruhr-University, Bochum, Germany.

Division of Endocrinology, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina.

出版信息

Diabetes Obes Metab. 2019 Mar;21(3):525-532. doi: 10.1111/dom.13547. Epub 2018 Oct 25.

Abstract

AIMS

To assess health-related quality of life (HRQoL) in people with type 2 diabetes (T2D) participating in the LEADER cardiovascular outcomes trial using the five-dimension European Quality of Life questionnaire (EQ-5D).

MATERIALS AND METHODS

The EQ-5D was administered every 12 months in a subset of patients from Canada, Denmark, Germany, Ireland, Italy, Netherlands, Spain, Sweden, the United Kingdom and the United States. We compared changes in utility index scores and visual analogue scale (VAS) scores from baseline to 36 months in participants treated with liraglutide and placebo. We also assessed which complications had the greatest impact on quality of life.

RESULTS

At 36 months, less deterioration in EQ-5D utility index score was seen in the liraglutide group (-0.058) than in the placebo group (-0.082; estimated treatment difference [ETD] 0.023, 95% confidence interval [CI] 0.004;0.043; P = 0.020). A smaller decrease in EQ-5D VAS score was also demonstrated in the liraglutide group (-3.51) vs. the placebo group (-5.45; ETD 1.94, 95% CI 0.32;3.57; P = 0.019). The benefits of liraglutide treatment compared with placebo were driven primarily by shifts in the domains of mobility and self-care. The most influential events contributing to poorer HRQoL were stroke, heart failure, malignant neoplasm and confirmed hypoglycaemia.

CONCLUSIONS

Liraglutide demonstrated a modest but significant benefit in patient-reported health status using the EQ-5D, compared with placebo. This benefit may be of clinical relevance and requires further study.

摘要

目的

使用五维欧洲健康调查问卷(EQ-5D)评估参加 LEADER 心血管结局试验的 2 型糖尿病(T2D)患者的健康相关生活质量(HRQoL)。

材料和方法

在来自加拿大、丹麦、德国、爱尔兰、意大利、荷兰、西班牙、瑞典、英国和美国的部分患者中,每 12 个月进行一次 EQ-5D 评估。我们比较了利拉鲁肽和安慰剂治疗组患者从基线到 36 个月时效用指数评分和视觉模拟量表(VAS)评分的变化。我们还评估了哪些并发症对生活质量的影响最大。

结果

36 个月时,利拉鲁肽组的 EQ-5D 效用指数评分恶化程度低于安慰剂组(-0.058 比-0.082;估计治疗差异 [ETD] 0.023,95%置信区间 [CI] 0.004;0.043;P = 0.020)。利拉鲁肽组的 EQ-5D VAS 评分下降也较小(-3.51 比-5.45;ETD 1.94,95%CI 0.32;3.57;P = 0.019)。与安慰剂相比,利拉鲁肽治疗的益处主要归因于移动性和自理能力领域的变化。导致 HRQoL 恶化的最主要事件是中风、心力衰竭、恶性肿瘤和确诊低血糖。

结论

与安慰剂相比,利拉鲁肽在患者报告的健康状况方面显示出适度但显著的益处,使用 EQ-5D 评估。这种益处可能具有临床相关性,需要进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/938b/6587748/0ad959bb9525/DOM-21-525-g002.jpg

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