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利格列汀,钠-葡萄糖共转运蛋白 1 和钠-葡萄糖共转运蛋白 2 的双重抑制剂,在慢性肾脏病患者中的糖脲、肾脏和血液动力学效应:一项随机试验。

Glucosuric, renal and haemodynamic effects of licogliflozin, a dual inhibitor of sodium-glucose co-transporter-1 and sodium-glucose co-transporter-2, in patients with chronic kidney disease: A randomized trial.

机构信息

Novartis Institutes for BioMedical Research, Cambridge, Massachusetts, USA.

Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, USA.

出版信息

Diabetes Obes Metab. 2021 May;23(5):1182-1190. doi: 10.1111/dom.14327. Epub 2021 Feb 16.

DOI:10.1111/dom.14327
PMID:33512754
Abstract

AIM

To investigate the glucosuric, renal and haemodynamic effects of licogliflozin, a dual sodium-glucose co-transporter-1 and sodium-glucose co-transporter-2 inhibitor, in patients with chronic kidney disease (CKD).

METHODS

This multiple-dose, parallel-group, phase II mechanistic study randomized 53 participants (aged 18-78 years, body mass index ≤ 50 kg/m ) with varying degrees of CKD or normal renal function to treatment with licogliflozin (50 mg once daily) or placebo for 7 days. The effects of licogliflozin on 24-h urinary glucose excretion (UGE ), renal function, haemodynamics, pharmacokinetics and safety were assessed.

RESULTS

Licogliflozin treatment for 7 days significantly (p < .01) increased UGE from baseline in participants with normal renal function (adjusted mean change: 41.8 [33.6, 49.9] g) or with mild (32.6 [24.1, 41.0] g), moderate A (35.7 [28.6, 42.9] g) or moderate B (20.3 [13.1, 27.5] g) CKD, but not in severe (6.2 [-0.71, 13.18] g) CKD. Licogliflozin reduced urinary electrolytes (sodium, potassium and chloride), blood pressure and urinary volume to varying extents among different groups. Significant increases in renin (p < .05), angiotensin II (p < .05) and aldosterone (p < .01) levels were observed. Adverse events were generally mild, and most commonly included diarrhoea (94%), flatulence (68%) and abdominal pain (21%).

CONCLUSION

Licogliflozin treatment results in significantly increased UGE and favourable changes in urinary electrolytes and haemodynamics in patients with varying degrees of CKD (estimated glomerular filtration rate ≥ 45 mL/min/1.73 m ).

摘要

目的

研究利格列汀作为一种新型钠-葡萄糖共转运蛋白 1 和 2 抑制剂,在慢性肾脏病(CKD)患者中的降血糖、肾脏和血液动力学作用。

方法

本项多剂量、平行分组、II 期机制研究将 53 名年龄在 18-78 岁之间、体重指数(BMI)≤50kg/m 的 CKD 或肾功能正常的患者随机分为利格列汀(50mg 每日一次)或安慰剂治疗组,治疗 7 天。评估利格列汀对 24 小时尿葡萄糖排泄量(UGE)、肾功能、血液动力学、药代动力学和安全性的影响。

结果

利格列汀治疗 7 天可显著增加肾功能正常(校正平均变化:41.8[33.6,49.9]g)或轻度(32.6[24.1,41.0]g)、中度 A(35.7[28.6,42.9]g)或中度 B(20.3[13.1,27.5]g)CKD 患者的 UGE,而对严重(6.2[-0.71,13.18]g)CKD 患者无影响。利格列汀可不同程度地减少不同组别患者的尿电解质(钠、钾和氯)、血压和尿量。观察到肾素(p<0.05)、血管紧张素 II(p<0.05)和醛固酮(p<0.01)水平显著升高。不良事件一般为轻度,最常见的是腹泻(94%)、气胀(68%)和腹痛(21%)。

结论

利格列汀治疗可使不同程度 CKD(估计肾小球滤过率≥45ml/min/1.73m )患者的 UGE 显著增加,并使尿电解质和血液动力学发生有利变化。

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