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在二甲双胍单药治疗控制不佳的 2 型糖尿病患者中,恩格列净的长期疗效和安全性:104 周的 VERTIS MET 试验。

Long-term efficacy and safety of ertugliflozin in patients with type 2 diabetes mellitus inadequately controlled with metformin monotherapy: 104-week VERTIS MET trial.

机构信息

Pfizer Deutschland GmbH, Berlin, Germany.

University of Nantes, Nantes, France.

出版信息

Diabetes Obes Metab. 2019 Apr;21(4):1027-1036. doi: 10.1111/dom.13631. Epub 2019 Feb 14.

Abstract

AIM

To evaluate the long-term efficacy and safety of ertugliflozin in adults with type 2 diabetes mellitus inadequately controlled on metformin.

MATERIALS AND METHODS

A 104-week Phase III, randomized double-blind study with a 26-week placebo-controlled period (Phase A) and a 78-week period (Phase B) where blinded glimepiride was added to non-rescued placebo participants with fasting fingerstick glucose ≥6.1 mmol/L. Results through week 104 are reported.

RESULTS

Mean (standard error) change in HbA1c from baseline was -0.7% (0.07) and -1.0% (0.07) at week 52; -0.6% (0.08) and -0.9% (0.08) at week 104 for ertugliflozin 5 and 15 mg. At week 52, 34.8% and 36.6% participants had HbA1c <7.0%, and 24.6% and 33.7% at week 104, for ertugliflozin 5 and 15 mg. Ertugliflozin reduced fasting plasma glucose (FPG), body weight and systolic blood pressure (SBP) from baseline through week 104. The incidence of female genital mycotic infections (GMIs) was higher with ertugliflozin, and symptomatic hypoglycaemia was lower for ertugliflozin versus placebo/glimepiride. Minimal bone mineral density (BMD) changes were observed, similar to placebo/glimepiride, except at total hip where reduction in BMD was greater with ertugliflozin 15 mg versus placebo/glimepiride: difference in least squares means (95% CI) -0.50% (-0.95, -0.04) at week 52 and -0.84% (-1.44, -0.24) at week 104.

CONCLUSIONS

Ertugliflozin maintained improvements from baseline in HbA1c, FPG, body weight and SBP through week 104. Ertugliflozin was well tolerated, with non-clinically relevant changes in BMD. Compared with placebo/glimepiride, ertugliflozin increased female GMIs, but reduced the incidence of symptomatic hypoglycaemia. ClinicalTrials.gov Identifier: NCT02033889.

摘要

目的

评估依格列净在二甲双胍控制不佳的 2 型糖尿病成人患者中的长期疗效和安全性。

材料与方法

这是一项为期 104 周的 III 期、随机、双盲研究,包括 26 周的安慰剂对照期(A 期)和 78 周的期(B 期),在该期,空腹指尖血糖≥6.1mmol/L 的未挽救安慰剂参与者加用双盲格列美脲。报告了第 104 周的结果。

结果

从基线开始,依格列净治疗 5 周和 104 周时 HbA1c 的平均(标准误差)变化分别为-0.7%(0.07)和-1.0%(0.07);-0.6%(0.08)和-0.9%(0.08)。在第 52 周时,34.8%和 36.6%的患者 HbA1c<7.0%,在第 104 周时,分别为 24.6%和 33.7%,分别为依格列净 5mg 和 15mg。依格列净可降低空腹血浆葡萄糖(FPG)、体重和收缩压(SBP),从基线到第 104 周。依格列净组女性生殖道真菌感染(GMIs)的发生率较高,与安慰剂/格列美脲相比,依格列净组的症状性低血糖发生率较低。与安慰剂/格列美脲相比,骨密度(BMD)的变化最小,除了总髋部,依格列净 15mg 组的 BMD 降低大于安慰剂/格列美脲组:最小二乘均值(95%CI)差异分别为-0.50%(-0.95,-0.04)在第 52 周和-0.84%(-1.44,-0.24)在第 104 周。

结论

依格列净在第 104 周时保持了 HbA1c、FPG、体重和 SBP 的改善。依格列净耐受性良好,BMD 无临床相关变化。与安慰剂/格列美脲相比,依格列净增加了女性 GMIs,但降低了症状性低血糖的发生率。临床试验注册号:NCT02033889。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39e6/6593724/d0952135dac6/DOM-21-1027-g001.jpg

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