Department of Metabolic Medicine, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.
Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Diabetes Obes Metab. 2020 Apr;22(4):540-548. doi: 10.1111/dom.13922. Epub 2019 Dec 26.
To investigate the safety and tolerability of 5 and 10 mg dapagliflozin added to insulin therapy over 52 weeks in Japanese patients with inadequately controlled type 1 diabetes mellitus (T1DM).
This randomized, open-label, parallel-group, multicentre phase III clinical trial was conducted from October 26, 2015 to June 15, 2017. The primary endpoint was the occurrence of adverse events such as hypoglycaemia and diabetic ketoacidosis. Secondary endpoints included changes in glycaemic parameters, total daily insulin dosage and body weight over time. The efficacy of dapagliflozin in patients stratified by body mass index (BMI) <25.0 and ≥25.0 kg/m was evaluated in a subgroup analysis.
In total, 151 patients received 5 mg (n = 76) or 10 mg (n = 75) dapagliflozin once daily for 52 weeks. Adverse events were observed in 88.2% and 73.3% of patients in the 5 and 10 mg dapagliflozin groups, respectively. Severe hypoglycaemia was reported in 2.6% (n = 2) and 6.7% (n = 5) of patients, and diabetic ketoacidosis in 2.6% (n = 2) and 1.3% (n = 1) of patients in the 5 and 10 mg dapagliflozin groups, respectively. The adjusted mean (95% confidence interval) changes in glycated haemoglobin at week 52 were -0.33% (-0.50, -0.15) and -0.36% (-0.53, -0.18) in the 5 and 10 mg dapagliflozin groups, respectively. There were no differences in efficacy parameters when stratified by BMI.
This study demonstrated the long-term safety and tolerability of dapagliflozin added to insulin therapy in Japanese patients with inadequately controlled T1DM.
评估在胰岛素治疗的基础上加用达格列净 5mg 和 10mg 治疗 52 周对血糖控制不佳的 1 型糖尿病(T1DM)日本患者的安全性和耐受性。
这是一项于 2015 年 10 月 26 日至 2017 年 6 月 15 日进行的随机、开放标签、平行分组、多中心 III 期临床试验。主要终点是低血糖和糖尿病酮症酸中毒等不良事件的发生情况。次要终点包括随时间变化的血糖参数、总日胰岛素剂量和体重的变化。在亚组分析中,还评估了达格列净在按体质指数(BMI)<25.0 和≥25.0kg/m 分层的患者中的疗效。
共有 151 例患者接受了 5mg(n=76)或 10mg(n=75)达格列净每日一次治疗 52 周。5mg 和 10mg 达格列净组分别有 88.2%和 73.3%的患者发生不良事件。2.6%(n=2)和 6.7%(n=5)的患者发生严重低血糖,2.6%(n=2)和 1.3%(n=1)的患者发生糖尿病酮症酸中毒。在第 52 周时,糖化血红蛋白的调整平均(95%置信区间)变化分别为-0.33%(-0.50,-0.15)和-0.36%(-0.53,-0.18)。按 BMI 分层时,疗效参数无差异。
这项研究表明,在胰岛素治疗的基础上加用达格列净治疗血糖控制不佳的 T1DM 日本患者,具有长期的安全性和耐受性。