Department of Nephrology, Endocrinology and Metabolism, Keio University School of Medicine, Tokyo, Japan.
Japan Medical Affairs, Takeda Pharmaceutical Company Limited, Tokyo, Japan.
Curr Med Res Opin. 2019 Dec;35(12):2071-2078. doi: 10.1080/03007995.2019.1651130. Epub 2019 Aug 22.
To examine patient preference for treatment with the oral once-weekly dipeptidyl peptidase-4 inhibitor (DPP-4i), trelagliptin, and oral once-daily DPP-4i, alogliptin, administered for 8 weeks each in patients with type 2 diabetes mellitus prescribed a daily DPP-4i. In this randomized, open-label, two-way crossover study, patients received trelagliptin followed by alogliptin (T-A group) or alogliptin followed by trelagliptin (A-T group), for 8 weeks each (NCT03231709, JapicCTI-173662). Treatment preference was assessed using a standardized questionnaire in the overall population and by baseline characteristics. Other outcomes included patient satisfaction with diabetes treatment (assessed using the Diabetes Treatment Satisfaction Questionnaire [DTSQ]), hemoglobin A1c (HbA1c) levels after 8 weeks of treatment with each agent, and safety. Sixty patients from two clinical sites were randomized 1:1 to T-A and A-T groups (each = 30); baseline characteristics were similar between groups. After 16 weeks of treatment, 51.7% of patients preferred treatment with alogliptin compared with 30.0% selecting trelagliptin ( = .014); preference for alogliptin was consistently greater than for trelagliptin in the secondary analyses by baseline characteristics. DTSQ score and HbA1c levels were similar between treatments after 8 weeks of therapy. Both treatments demonstrated favorable safety and tolerability profiles. Patients expressed a significantly greater treatment preference for once-daily alogliptin than once-weekly trelagliptin, although patient satisfaction and HbA1c levels were similar across treatments. The decision to administer a once-weekly or once-daily DPP-4i is likely to depend on patient preference, patient-physician discussions, and treatment practices of the prescribing physician.
为了研究 2 型糖尿病患者在接受每周一次的二肽基肽酶-4 抑制剂（DPP-4i）替格列汀和每日一次的 DPP-4i 阿格列汀治疗 8 周后，对治疗的偏好，每种药物治疗 8 周。在这项随机、开放标签、双向交叉研究中，患者接受替格列汀治疗，然后接受阿格列汀治疗（T-A 组）或阿格列汀治疗，然后接受替格列汀治疗（A-T 组），每组治疗 8 周（NCT03231709，JapicCTI-173662）。使用标准化问卷在总体人群中以及根据基线特征评估治疗偏好。其他结局包括患者对糖尿病治疗的满意度（使用糖尿病治疗满意度问卷[DTSQ]评估）、每种药物治疗 8 周后的血红蛋白 A1c（HbA1c）水平以及安全性。两个临床地点的 60 名患者按 1:1 随机分为 T-A 和 A-T 组（每组 30 名）；两组之间的基线特征相似。治疗 16 周后，51.7%的患者更喜欢阿格列汀治疗，而 30.0%的患者选择替格列汀治疗（ = .014）；在按基线特征进行的二次分析中，阿格列汀的偏好始终大于替格列汀。治疗 8 周后，DTSQ 评分和 HbA1c 水平在两种治疗之间相似。两种治疗均表现出良好的安全性和耐受性。患者对每日一次的阿格列汀的治疗偏好明显大于每周一次的替格列汀，尽管治疗满意度和 HbA1c 水平在治疗之间相似。每周一次或每日一次 DPP-4i 的给药决定可能取决于患者的偏好、医患讨论以及处方医生的治疗实践。
