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在心血管疾病风险增加的 2 型糖尿病患者中,每周给予 expanded dulaglutide 3.0mg 和 4.5mg 剂量对心血管疾病危险因素的影响:AWARD-11 研究的事后分析。

Effect of expanded dulaglutide weekly doses (3.0 mg and 4.5 mg) on cardiovascular disease risk factors in participants with type 2 diabetes at increased cardiovascular disease risk: a post hoc analysis of the AWARD-11 study.

机构信息

Eli Lilly and Company, Indianapolis, Indiana, USA.

TechData Service Company, King of Prussia, Pennsylvania, USA.

出版信息

Diabetes Obes Metab. 2022 Sep;24(9):1770-1778. doi: 10.1111/dom.14762. Epub 2022 May 29.

Abstract

AIMS

This post hoc analysis investigated the effect of dulaglutide on cardiovascular disease (CVD) risk factors in subgroups of participants at increased CVD risk in the AWARD-11 study.

METHODS

Participants who received once weekly dulaglutide 1.5, 3.0 or 4.5 mg for 52 weeks were categorized according to their baseline Framingham CVD risk category [low (N = 295), medium (N = 481) and high (N = 1054) risk], as well as their baseline CVD risk according to the REWIND study eligibility criteria (N = 953). Serum lipids and vital signs were assessed at baseline and at 52 weeks. Data were analysed as least squares mean percentage change from baseline for lipids and least squares mean change from baseline for vital signs.

RESULTS

Demographic and baseline clinical characteristics were balanced across doses within the CVD risk groups. In the high Framingham CVD risk and REWIND-like groups, dulaglutide resulted in dose-related decreases in total cholesterol (≤6.0%), non-high-density lipoprotein cholesterol (≤8.8%), very-low-density lipoprotein cholesterol (≤19.4%) and triglycerides (≤21.5%), with little change in low-density lipoprotein cholesterol and high-density lipoprotein cholesterol. Systolic and diastolic blood pressure decreased up to 5.6 mmHg and 1.6 mmHg, respectively, and heart rate increased up to 2 beats/min.

CONCLUSIONS

This post hoc analysis suggests the magnitude of the favourable effects of dulaglutide 3.0 mg and 4.5 mg on several cardiometabolic CVD risk factors was similar to, if not greater than, those of dulaglutide 1.5 mg among participants with type 2 diabetes and increased CVD risk.

CLINICALTRIALS

gov Identifier: NCT03495102.

摘要

目的

这项事后分析旨在探讨 AWARD-11 研究中具有较高心血管疾病(CVD)风险的参与者亚组中,度拉鲁肽对 CVD 风险因素的影响。

方法

接受每周一次度拉鲁肽 1.5、3.0 或 4.5mg 治疗 52 周的患者,根据基线Framingham CVD 风险类别(低风险[N=295]、中风险[N=481]和高风险[N=1054])以及根据 REWIND 研究入选标准的基线 CVD 风险(N=953)进行分类。在基线和 52 周时评估血清脂质和生命体征。数据以脂质的最小二乘均数百分比变化和生命体征的最小二乘均数变化进行分析。

结果

在 CVD 风险组内,各剂量组的人口统计学和基线临床特征均衡。在高 Framingham CVD 风险和 REWIND 样组中,度拉鲁肽与剂量相关,总胆固醇(≤6.0%)、非高密度脂蛋白胆固醇(≤8.8%)、极低密度脂蛋白胆固醇(≤19.4%)和甘油三酯(≤21.5%)降低,而低密度脂蛋白胆固醇和高密度脂蛋白胆固醇变化不大。收缩压和舒张压分别降低了 5.6mmHg 和 1.6mmHg,心率增加了 2 次/分钟。

结论

这项事后分析表明,在 2 型糖尿病和 CVD 风险增加的患者中,度拉鲁肽 3.0mg 和 4.5mg 对几种心血管代谢 CVD 风险因素的有利影响的幅度与度拉鲁肽 1.5mg 相似,如果不是更大的话。

临床试验

gov 标识符:NCT03495102。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/34bc/9543252/6fde46c20446/DOM-24-1770-g002.jpg

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