Department of Internal Medicine, Daejin Medical Center, Seongnam, Korea.
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Diabetes Obes Metab. 2019 Mar;21(3):631-639. doi: 10.1111/dom.13566. Epub 2018 Nov 22.
To assess the efficacy and safety of add-on therapy with the dipeptidyl peptidase-4 inhibitor teneligliptin compared with sitagliptin in patients with type 2 diabetes (T2DM) inadequately controlled with metformin and glimepiride.
This was a phase 3, randomized, double-blind, non-inferiority study of adult Korean subjects with T2DM (n = 201), with HbA1c ranging from 7.0% to 11.0%, on stable doses of metformin plus glimepiride. Subjects were randomized in a 1:1 fashion to receive either oral teneligliptin 20 mg or sitagliptin 100 mg for 24 weeks. The primary endpoint was change from baseline in HbA1c.
At baseline, mean age was 60.56 ± 9.41 years, body mass index was 25.23 ± 2.85 kg/m and HbA1c was 8.11% ± 0.79%. At 24 weeks, both groups achieved significant reductions from baseline in HbA1c (teneligliptin, -1.03% ± 0.10% [P < 0.0001]; sitagliptin, -1.02% ± 0.10% [P < 0.0001]). The inter-group difference was -0.01% (95% confidence interval [CI]: -0.28, 0.26; P = 0.9497); the upper limit of the 95% CI was within the preset limit for non-inferiority (0.4%). There were no significant differences between groups in the proportion of patients achieving HbA1c targets, or changes from baseline in fasting plasma glucose, body weight or lipid levels at 24 weeks. Rates of adverse events (teneligliptin, n = 63 [61.76%]; sitagliptin, n = 61 [62.24%]; P = 0.9442) and hypoglycaemia (teneligliptin, n = 32 [31.37%]; sitagliptin, n = 28 [28.57%]; P = 0.6656) were similar.
Teneligliptin was non-inferior to sitagliptin in the context of triple therapy for T2DM and is an important option in this setting.
评估二肽基肽酶-4 抑制剂替格列汀与西他列汀联合二甲双胍和格列美脲治疗 2 型糖尿病(T2DM)的疗效和安全性,患者血糖控制不佳。
这是一项 3 期、随机、双盲、非劣效性研究,纳入了 201 例年龄在 18 岁及以上、HbA1c 为 7.0%至 11.0%、接受稳定剂量二甲双胍加格列美脲治疗的韩国 T2DM 受试者。受试者以 1:1 的比例随机接受替格列汀 20mg 或西他列汀 100mg 治疗 24 周。主要终点为 HbA1c 自基线的变化。
基线时,平均年龄为 60.56±9.41 岁,体重指数为 25.23±2.85kg/m2,HbA1c 为 8.11%±0.79%。24 周时,两组 HbA1c 均显著降低(替格列汀,-1.03%±0.10%[P<0.0001];西他列汀,-1.02%±0.10%[P<0.0001])。组间差异为-0.01%(95%置信区间:-0.28,0.26;P=0.9497);95%置信区间上限在预设的非劣效性界限(0.4%)内。两组患者 HbA1c 达标率、空腹血糖、体重或血脂水平自基线的变化在 24 周时无显著差异。不良事件发生率(替格列汀,63 例[61.76%];西他列汀,61 例[62.24%];P=0.9442)和低血糖发生率(替格列汀,32 例[31.37%];西他列汀,28 例[28.57%];P=0.6656)相似。
在三联治疗 T2DM 方面,替格列汀与西他列汀非劣效,是该治疗方案的重要选择。