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在真实临床实践中,托格列净在日本 2 型糖尿病患者中的安全性和疗效:一项长期上市后监测研究(J-STEP/LT)的 3 个月中期分析结果。

Safety and efficacy of tofogliflozin in Japanese patients with type 2 diabetes mellitus in real-world clinical practice: Results of 3-month interim analysis of a long-term post-marketing surveillance study (J-STEP/LT).

机构信息

Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan.

Medical Affairs, Sanofi K.K., Tokyo, Japan.

出版信息

J Diabetes Investig. 2019 Sep;10(5):1272-1283. doi: 10.1111/jdi.13017. Epub 2019 Mar 6.

Abstract

AIMS/INTRODUCTION: The present study analysis was carried out to evaluate the safety and efficacy of tofogliflozin, a sodium-glucose cotransporter 2 inhibitor, in Japanese patients with type 2 diabetes mellitus in real-world clinical practice.

MATERIALS AND METHODS

This was a 3-year non-interventional observational study of patients with type 2 diabetes mellitus newly administered tofogliflozin who were uncontrolled on current therapy. We carried out a 12-week interim analysis of tofogliflozin as part of 3-year post-marketing surveillance study. The incidence of adverse drug reactions was evaluated as a safety end-point. As efficacy end-points, glycated hemoglobin and bodyweight were evaluated.

RESULTS

A total of 6,897 patients were enrolled. Tofogliflozin significantly reduced mean changes from baseline glycated hemoglobin (-0.63%, P < 0.0001) and bodyweight (-2.02 kg, P < 0.0001). The change in glycated hemoglobin and bodyweight reductions in response to tofogliflozin was consistently observed in all body mass index subgroups. Adverse drug reactions occurred in 345 of 6,712 patients (5.14%). There was a low incidence of adverse drug reactions known to be associated with sodium-glucose cotransporter 2 inhibitors, and they were reported as non-serious. The incidences of polyuria/pollakiuria were higher in patients aged ≥65 years than <65 years, and were significantly different among estimated glomerular filtration rate subgroups. Urinary tract and genital infections occurred more frequently in women than in men.

CONCLUSIONS

Tofogliflozin was well tolerated, and no emerging new safety concerns were observed. Tofogliflozin significantly improved glycemic control with no impact on bodyweight gain. The short-term administration of tofogliflozin is considered to have a favorable benefit-risk profile in Japanese patients with type 2 diabetes mellitus.

摘要

目的/引言:本研究分析旨在评估钠-葡萄糖共转运蛋白 2 抑制剂托格列净在日本 2 型糖尿病患者真实临床实践中的安全性和疗效。

材料和方法

这是一项对新接受托格列净治疗且当前治疗控制不佳的 2 型糖尿病患者进行的为期 3 年的非干预性观察研究。我们对托格列净进行了为期 12 周的中期分析,作为 3 年上市后监测研究的一部分。不良反应的发生率作为安全性终点进行评估。作为疗效终点,评估糖化血红蛋白和体重。

结果

共纳入 6897 例患者。托格列净显著降低了平均基线糖化血红蛋白(-0.63%,P<0.0001)和体重(-2.02kg,P<0.0001)的变化。在所有体重指数亚组中,托格列净均能持续观察到糖化血红蛋白和体重减轻的变化。在 6712 例患者中有 345 例(5.14%)发生不良反应。与钠-葡萄糖共转运蛋白 2 抑制剂相关的不良反应发生率较低,且报告为非严重不良反应。年龄≥65 岁的患者比<65 岁的患者多尿/多尿的发生率更高,且在估计肾小球滤过率亚组之间存在显著差异。女性比男性更容易发生尿路感染和生殖器感染。

结论

托格列净耐受性良好,未观察到新的安全性问题。托格列净显著改善了血糖控制,而体重无增加。托格列净的短期给药在日本 2 型糖尿病患者中被认为具有良好的获益风险特征。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f3ef/6717810/faba9479472a/JDI-10-1272-g001.jpg

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