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亨格列净作为二甲双胍治疗控制不佳的 2 型糖尿病患者的附加疗法:一项多中心、随机、双盲、安慰剂对照的 3 期临床试验。

Henagliflozin as add-on therapy to metformin in patients with type 2 diabetes inadequately controlled with metformin: A multicentre, randomized, double-blind, placebo-controlled, phase 3 trial.

机构信息

Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China.

Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.

出版信息

Diabetes Obes Metab. 2021 Aug;23(8):1754-1764. doi: 10.1111/dom.14389. Epub 2021 Apr 14.

DOI:10.1111/dom.14389
PMID:33769656
Abstract

AIM

To evaluate the efficacy and safety of henagliflozin in patients with type 2 diabetes mellitus (T2DM) inadequately controlled with metformin.

MATERIAL AND METHODS

This multicentre phase 3 trial included a 24-week randomized, double-blind, placebo-controlled period, followed by a 28-week extension period. Patients with a glycated haemoglobin (HbA1c) level of 7.0% (53 mmol/mol) to 10.5% (91 mmol/mol) were randomized and treated with once-daily placebo (n = 161), henagliflozin 5 mg (n = 162), or henagliflozin 10 mg (n = 160). After 24 weeks, patients on placebo were switched to 5 mg or 10 mg henagliflozin for the additional 28-week treatment, and patients on henagliflozin during 24-week treatment period maintained this initial therapy. The primary endpoint was change in HbA1c from baseline to Week 24.

RESULTS

At Week 24, the least squares mean HbA1c changes versus placebo from baseline were - 0.76% (-8.3 mmol/mol) and - 0.80% (-8.7 mmol/mol) for henagliflozin 5 and 10 mg, respectively (all P < 0.0001). Compared with the placebo group, both doses of henagliflozin lowered fasting plasma glucose, 2-hour postprandial plasma glucose, body weight and blood pressure, and increased the proportions of patients achieving HbA1c <7.0% (53 mmol/mol) at Week 24. The trends in these improvements were sustained over an additional 28 weeks. Slightly higher proportions of ketosis and presence of urine ketone bodies were observed in patients treated with henagliflozin compared to placebo at Week 24. No diabetic ketoacidosis or episodes of severe hypoglycaemia were reported.

CONCLUSIONS

Henagliflozin 5 mg or 10 mg as add-on therapy to metformin provided a new therapeutic option for the treatment of T2DM patients who have inadequate glycaemic control with metformin alone, and was generally well tolerated.

摘要

目的

评估亨格列净在二甲双胍血糖控制不佳的 2 型糖尿病(T2DM)患者中的疗效和安全性。

材料和方法

这是一项多中心 3 期试验,包括 24 周的随机、双盲、安慰剂对照期,随后是 28 周的扩展期。将糖化血红蛋白(HbA1c)水平为 7.0%(53mmol/mol)至 10.5%(91mmol/mol)的患者随机分为每日一次安慰剂(n=161)、亨格列净 5mg(n=162)或 10mg(n=160)组。24 周后,安慰剂组患者换用 5mg 或 10mg 亨格列净进行额外的 28 周治疗,而在 24 周治疗期间使用亨格列净的患者维持初始治疗。主要终点为从基线到 24 周时 HbA1c 的变化。

结果

在 24 周时,与安慰剂相比,亨格列净 5mg 和 10mg 组的 HbA1c 从基线的最小二乘均值变化分别为-0.76%(-8.3mmol/mol)和-0.80%(-8.7mmol/mol)(均 P<0.0001)。与安慰剂组相比,两种剂量的亨格列净均降低了空腹血糖、餐后 2 小时血糖、体重和血压,并增加了在第 24 周时 HbA1c<7.0%(53mmol/mol)的患者比例。这些改善的趋势在额外的 28 周内持续存在。与安慰剂组相比,在第 24 周时,接受亨格列净治疗的患者中酮症和尿酮体的比例略高。未报告糖尿病酮症酸中毒或严重低血糖发作。

结论

亨格列净 5mg 或 10mg 作为二甲双胍的附加疗法为单独使用二甲双胍血糖控制不佳的 T2DM 患者提供了一种新的治疗选择,且总体耐受性良好。

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