a Baylor Endocrine Center , Dallas , TX , USA.
b Merck & Co. Inc. , Kenilworth , NJ , USA.
Curr Med Res Opin. 2019 Aug;35(8):1335-1343. doi: 10.1080/03007995.2019.1583450. Epub 2019 Mar 25.
To assess the safety and efficacy of ertugliflozin over 104 weeks in patients with type 2 diabetes mellitus (T2DM) inadequately controlled on metformin. In this double-blind, multicenter, randomized, phase III study (VERTIS SU; NCT01999218), adults with T2DM and glycated hemoglobin (HbA1c) 7.0-9.0% on metformin ≥1500 mg/day received ertugliflozin 5 mg or 15 mg, or glimepiride. The primary efficacy time point was Week 52; double-blinded treatment continued until Week 104. Baseline characteristics of randomized, treated patients ( = 1315) were similar across groups (mean age 58.2 years, HbA1c 7.8%); 76.4% completed the study; 61.6% completed on study medication. Mean glimepiride dose at 104 weeks was 3.5 mg/day. At Week 104, least squares mean change from baseline in HbA1c (95% confidence intervals) were -0.3% (-0.4, -0.2), -0.4% (-0.5, -0.3) and -0.4% (-0.5, -0.3) for ertugliflozin 5 mg, 15 mg, and glimepiride, respectively. Ertugliflozin provided sustained reductions in body weight and systolic blood pressure (SBP) over 104 weeks. The incidence of adverse events (AEs) and serious AEs was similar across groups. The incidence of symptomatic hypoglycemia was 3.8%, 6.4% and 22.1% in the ertugliflozin 5 mg, 15 mg, and glimepiride groups, respectively. Genital mycotic infections were reported in 5.3%, 2.6% and 0% of men, respectively, and 9.2%, 12.3% and 1.4% of women, respectively. The incidence of urinary tract infection and hypovolemia AEs was similar across groups. Ertugliflozin was well tolerated and provided clinically meaningful glycemic control and durable reductions in body weight and SBP over 104 weeks.
评估恩格列净在二甲双胍控制不佳的 2 型糖尿病(T2DM)患者中超过 104 周的安全性和疗效。在这项双盲、多中心、随机、III 期研究(VERTIS SU;NCT01999218)中,接受二甲双胍≥1500mg/天且糖化血红蛋白(HbA1c)为 7.0-9.0%的 T2DM 成人患者接受恩格列净 5mg 或 15mg 或格列美脲治疗。主要疗效时间点为第 52 周;双盲治疗持续至第 104 周。随机、治疗患者(n=1315)的基线特征在各组间相似(平均年龄 58.2 岁,HbA1c 7.8%);76.4%完成了研究;61.6%完成了研究药物治疗。第 104 周时,平均格列美脲剂量为 3.5mg/天。第 104 周时,从基线的最小平方均数变化(95%置信区间)分别为恩格列净 5mg、15mg 和格列美脲组的-0.3%(-0.4,-0.2)、-0.4%(-0.5,-0.3)和-0.4%(-0.5,-0.3)。恩格列净在 104 周时持续降低体重和收缩压(SBP)。各组间不良事件(AE)和严重 AE 的发生率相似。恩格列净 5mg、15mg 和格列美脲组的症状性低血糖发生率分别为 3.8%、6.4%和 22.1%。分别有 5.3%、2.6%和 0%的男性患者和 9.2%、12.3%和 1.4%的女性患者报告生殖器真菌感染。尿路感染和血容量不足 AE 的发生率在各组间相似。恩格列净耐受性良好,可在 104 周时提供有临床意义的血糖控制,并持续降低体重和 SBP。