Kansai Electric Power Hospital, Osaka, Japan.
Kansai Electric Power Medical Research Institute, Osaka, Japan.
J Diabetes Investig. 2022 Aug;13(8):1321-1329. doi: 10.1111/jdi.13789. Epub 2022 Apr 8.
AIMS/INTRODUCTION: The present trial compared the efficacy and safety of once-daily liraglutide 1.8 mg with liraglutide 0.9 mg in Japanese patients with type 2 diabetes to assess the incremental effects of liraglutide 1.8 mg in those who exhibited an inadequate response to 0.9 mg.
This 26-week randomized trial (NCT02505334) enrolled Japanese adults with type 2 diabetes across 47 sites in Japan. Participants with glycated hemoglobin (HbA ) 7.5-10.0% were included and those on insulin treatment were excluded. Participants discontinued pre-trial oral antidiabetic drug and initiated liraglutide 0.9 mg for a 12-week run-in period, after which those with HbA ≥7.0% (466) were randomized (1:1) to two treatment arms: continuing liraglutide 0.9 mg or dose escalation to 1.8 mg. The change from baseline in HbA (primary endpoint) and treatment-emergent adverse events (secondary endpoint) were measured at the end of 26 weeks.
After 26 weeks of treatment, liraglutide 1.8 mg was more effective compared with 0.9 mg in lowering HbA levels, with an estimated treatment difference of -0.40% (95% confidence interval [CI] -0.55, -0.24; P < 0.0001). Liraglutide 1.8 mg was associated with significantly greater odds of participants reaching HbA <7.0% (estimated odds ratio [EOR] 3.87; 95% CI 2.12, 7.08; P < 0.0001) and ≤6.5% (EOR 3.78; 95% CI 1.36, 10.54; P = 0.0109) compared with 0.9 mg. Both doses were well tolerated.
Liraglutide 1.8 mg had better efficacy in improving HbA levels after 26 weeks treatment vs 0.9 mg in Japanese patients, with both doses well tolerated.
目的/引言:本试验比较了每日一次利拉鲁肽 1.8mg 与利拉鲁肽 0.9mg 在日本 2 型糖尿病患者中的疗效和安全性,以评估利拉鲁肽 1.8mg 对 0.9mg 应答不足患者的增量效果。
这是一项 26 周的随机试验(NCT02505334),纳入了日本 47 个研究中心的日本成年 2 型糖尿病患者。纳入糖化血红蛋白(HbA )为 7.5-10.0%的患者,排除正在接受胰岛素治疗的患者。所有患者在试验前停用口服降糖药物,进行为期 12 周的利拉鲁肽 0.9mg 导入期治疗,之后 HbA 仍≥7.0%(466 例)的患者按 1:1 随机分为两组:继续利拉鲁肽 0.9mg 或剂量增至 1.8mg。治疗 26 周后,测量 HbA 从基线的变化(主要终点)和治疗期间出现的不良事件(次要终点)。
治疗 26 周后,与利拉鲁肽 0.9mg 相比,利拉鲁肽 1.8mg 能更有效降低 HbA 水平,估计治疗差异为-0.40%(95%置信区间-0.55,-0.24;P<0.0001)。利拉鲁肽 1.8mg 使 HbA<7.0%(估计比值比[EOR]3.87;95%置信区间 2.12,7.08;P<0.0001)和≤6.5%(EOR 3.78;95%置信区间 1.36,10.54;P=0.0109)的达标率显著更高。两种剂量均具有良好的耐受性。
在日本 2 型糖尿病患者中,与利拉鲁肽 0.9mg 相比,利拉鲁肽 1.8mg 治疗 26 周后能更好地改善 HbA 水平,且两种剂量均具有良好的耐受性。