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维格列汀的安全性和疗效:2 型糖尿病日本患者与其他口服降糖药和胰岛素联合使用的 52 周上市后监测。

Safety and efficacy of vildagliptin: 52-week post-marketing surveillance of Japanese patients with type 2 diabetes in combination with other oral antidiabetics and insulin.

机构信息

Medical Division, Novartis Pharma K.K., Tokyo, Japan.

Regulatory Office Japan, Novartis Pharma K.K., Tokyo, Japan.

出版信息

Expert Opin Pharmacother. 2020 Jan;21(1):121-130. doi: 10.1080/14656566.2019.1685500. Epub 2019 Nov 5.

DOI:10.1080/14656566.2019.1685500
PMID:31689132
Abstract

: Vildagliptin is a dipeptidyl peptidase-4 inhibitor that reduces glycemia in patients with type 2 diabetes mellitus (T2DM). When approved in 2013, data on vildagliptin combined with >750 mg/day metformin in Japanese patients were limited. There is a need to confirm the safety and efficacy of vildagliptin in combination with oral antidiabetic drugs (OADs).: This 52-week post-marketing surveillance (PMS) observational study in Japanese T2DM patients evaluated the safety and efficacy of vildagliptin in combination with OADs including high-dose metformin or insulin but excluding combination with sulfonylureas alone.: During this survey of 3006 Japanese T2DM patients, 13.61% of patients experienced adverse events (AEs) and 2.20% reported a serious AE (SAE). The frequency of AEs/SAEs was similar when in combination with biguanides (12.93%/1.46%), metformin ≥1000 mg/day (12.92%/1.22%), metformin <1000 mg/day (12.62%/1.54%), thiazolidine derivatives (16.71%/2.86%), α-glucosidase inhibitors (13.18%/1.90%), rapid-acting insulin secretagogues  (glinides) (20.41%/5.71%), or insulin (15.87%/2.47%). The mean ± SD changes from baseline at endpoint in glycated hemoglobin and fasting blood glucose were -0.76 ± 1.27% and -23.3 ± 57.3 mg/dL, respectively, and these changes were consistent, regardless of concomitant OAD.: Long-term vildagliptin combination therapy is safe and effective in Japanese T2DM patients in real-world settings.

摘要

维格列汀是一种二肽基肽酶-4 抑制剂,可降低 2 型糖尿病(T2DM)患者的血糖。2013 年获批时,日本患者中有关维格列汀联合 750 毫克/天以上二甲双胍的数据有限。因此,需要确认维格列汀联合口服降糖药(OAD)的安全性和有效性。

这项在日本 T2DM 患者中开展的 52 周上市后监测(PMS)观察性研究评估了维格列汀联合 OAD(包括高剂量二甲双胍或胰岛素,但不包括与磺酰脲类药物的联合治疗)的安全性和有效性。

在这项对 3006 例日本 T2DM 患者的调查中,13.61%的患者发生了不良事件(AE),2.20%报告了严重不良事件(SAE)。与双胍类药物(12.93%/1.46%)、二甲双胍≥1000mg/天(12.92%/1.22%)、二甲双胍<1000mg/天(12.62%/1.54%)、噻唑烷二酮衍生物(16.71%/2.86%)、α-葡萄糖苷酶抑制剂(13.18%/1.90%)、速效胰岛素分泌剂(格列奈类)(20.41%/5.71%)或胰岛素(15.87%/2.47%)联合治疗时,AE/SAE 的发生频率相似。糖化血红蛋白和空腹血糖自基线至终点的平均变化值分别为-0.76±1.27%和-23.3±57.3mg/dL,这些变化在不同 OAD 联合治疗时是一致的。

在真实世界环境中,长期维格列汀联合治疗对日本 T2DM 患者是安全且有效的。

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