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一项评估西格列汀在血糖控制不佳的日本 2 型糖尿病患者中使用伊格列净的疗效和安全性的随机、安慰剂对照试验。

A randomized, placebo-controlled trial to assess the efficacy and safety of sitagliptin in Japanese patients with type 2 diabetes and inadequate glycaemic control on ipragliflozin.

机构信息

Kansai Electric Power Hospital, Osaka, Japan.

Kansai Electric Power Medical Research Institute, Osaka, Japan.

出版信息

Diabetes Obes Metab. 2021 Jun;23(6):1342-1350. doi: 10.1111/dom.14346. Epub 2021 Feb 28.

Abstract

AIMS

To investigate the efficacy, safety and tolerability of sitagliptin 50 mg once daily added to ipragliflozin 50 mg once daily monotherapy in Japanese patients with type 2 diabetes (T2D).

MATERIALS AND METHODS

Japanese patients with T2D and glycated haemoglobin (HbA1c) 7.0% to 10.0% while treated with ipragliflozin 50 mg once daily were randomized 1:1 to additional treatment with sitagliptin 50 mg once daily (N = 70) or matching placebo (N = 71) for 24 weeks. The primary efficacy endpoint was change in HbA1c at Week 24. Secondary efficacy endpoints were changes in 2-hour post-meal glucose (PMG), total PMG 0- to 2-hour area under the curve (AUC ), and fasting plasma glucose (FPG).

RESULTS

Baseline characteristics were similar in the two groups (mean age 55.5 years, mean baseline HbA1c 8.0%). After 24 weeks, the addition of sitagliptin provided significantly greater reduction in HbA1c compared to placebo (least squares [LS] mean difference -0.83% [95% confidence interval -1.05, -0.62]; P <0.001). Significant reductions were also observed in all secondary endpoints: LS mean differences from placebo in changes in 2-hour PMG, total PMG AUC , and FPG were -42.5 mg/dL, -67.0 mg·h/dL and -11.2 mg/dL, respectively (all P <0.001). The incidence of adverse events (AEs) overall and incidence of predefined AEs of clinical interest (symptomatic hypoglycaemia, urinary tract infection, genital infection, hypovolaemia and polyuria/pollakiuria) were similar in the two groups.

CONCLUSIONS

In Japanese patients with T2D, sitagliptin 50 mg once daily added to ipragliflozin 50 mg once daily monotherapy provided significant improvement in glycaemic control and was generally well tolerated. ClinicalTrials.gov: NCT02577016.

摘要

目的

评估每日一次口服西格列汀 50mg 联合吡格列酮 50mg 治疗日本 2 型糖尿病(T2D)患者的疗效、安全性和耐受性。

材料与方法

正在接受吡格列酮 50mg 每日一次治疗,糖化血红蛋白(HbA1c)为 7.0%至 10.0%的日本 T2D 患者,按 1:1 随机分为每日一次加用西格列汀 50mg(n=70)或匹配安慰剂(n=71)治疗 24 周。主要疗效终点为治疗 24 周时 HbA1c 的变化。次要疗效终点为餐后 2 小时血糖(PMG)、0 至 2 小时总 PMG 曲线下面积(AUC)和空腹血糖(FPG)的变化。

结果

两组患者的基线特征相似(平均年龄 55.5 岁,平均基线 HbA1c 8.0%)。治疗 24 周后,与安慰剂相比,西格列汀治疗组 HbA1c 显著降低(最小二乘均数差值-0.83%[95%置信区间-1.05%,-0.62%];P<0.001)。所有次要终点也均有显著改善:与安慰剂相比,西格列汀治疗组 2 小时 PMG、总 PMG AUC 和 FPG 的变化分别为-42.5mg/dL、-67.0mg·h/dL 和-11.2mg/dL(均 P<0.001)。两组患者的总体不良事件(AE)发生率和临床关注的特定 AE 发生率(症状性低血糖、尿路感染、生殖系统感染、血容量减少和多尿/烦渴)相似。

结论

在日本 T2D 患者中,西格列汀 50mg 每日一次联合吡格列酮 50mg 每日一次治疗可显著改善血糖控制,且总体耐受性良好。ClinicalTrials.gov:NCT02577016。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/21d6/8248366/678e08e5f592/DOM-23-1342-g002.jpg

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