Key Laboratory of Endocrinology, Ministry of Health, Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
Department of Endocrinology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.
Diabetes Obes Metab. 2022 Nov;24(11):2232-2240. doi: 10.1111/dom.14810. Epub 2022 Jul 22.
To evaluate the efficacy and safety of DBPR108 (prusogliptin), a novel dipeptidyl peptidase-4 (DPP-4) inhibitor, as an add-on therapy in patients with type 2 diabetes (T2D) that is inadequately controlled with metformin.
In this 24-week, multi-centre, randomized, double-blind, placebo-controlled, superiority, phase III study, adult T2D patients with HbA1c levels ranging from 7.0% to 9.5% on stable metformin were enrolled and randomized (2:1) into the DBPR108 + metformin and placebo + metformin groups. The primary endpoint was the change from baseline in HbA1c at week 24 of DBPR108 versus placebo as an add-on therapy to metformin.
At week 24, the least-square mean (standard error) change from baseline in HbA1c was significantly greater in the DBPR108 group (-0.70% [0.09%]) than in the placebo group (-0.07% [0.11%]) (P < .001), with a treatment difference of -0.63% (95% confidence interval: -0.87%, -0.39%) on the full analysis set. A higher proportion of patients achieved an HbA1c of 6.5% or less (19.7% vs. 8.5%) and an HbA1c of 7.0% or less (50.0% vs. 21.1%) at week 24 in the DBPR108 + metformin group. Furthermore, add-on DBPR108 produced greater reductions from baseline in fasting plasma glucose and 2-hour postprandial plasma glucose without causing weight gain. The overall frequency of adverse events was similar between the two groups.
DBPR108 as add-on therapy to metformin offered a significant improvement in glycaemic control, was superior to metformin monotherapy (placebo) and was safe and well-tolerated in patients with T2D that is inadequately controlled with metformin.
评估新型二肽基肽酶-4(DPP-4)抑制剂 DBPR108 作为二甲双胍控制不佳的 2 型糖尿病(T2D)患者的附加治疗的疗效和安全性。
在这项为期 24 周、多中心、随机、双盲、安慰剂对照、优效性、III 期研究中,纳入了 HbA1c 水平在稳定的二甲双胍治疗下为 7.0%至 9.5%的成年 T2D 患者,并按 2:1 的比例随机分为 DBPR108+二甲双胍组和安慰剂+二甲双胍组。主要终点是 DBPR108 与安慰剂作为二甲双胍的附加治疗在第 24 周时与基线相比 HbA1c 的变化。
在第 24 周时,DBPR108 组的 HbA1c 自基线的最小二乘均值(标准误差)变化明显大于安慰剂组(-0.70% [0.09%] 对 -0.07% [0.11%])(P <.001),在全分析集中的治疗差异为-0.63%(95%置信区间:-0.87%,-0.39%)。在 DBPR108+二甲双胍组中,更多的患者在第 24 周时达到了 HbA1c 为 6.5%或更低(19.7%对 8.5%)和 HbA1c 为 7.0%或更低(50.0%对 21.1%)。此外,DBPR108 的添加治疗还使空腹血糖和 2 小时餐后血糖自基线水平显著降低,而不会导致体重增加。两组的不良事件总发生率相似。
DBPR108 作为二甲双胍的附加治疗,在血糖控制方面有显著改善,优于二甲双胍单药治疗(安慰剂),并且在二甲双胍控制不佳的 T2D 患者中安全且耐受良好。