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在 2 型糖尿病患者中,由利拉鲁肽或度拉鲁肽转换为皮下司美格鲁肽可改善血糖控制和治疗满意度:一项多中心、前瞻性、随机、开放标签、平行组比较研究(SWITCH-SEMA1 研究)。

Improvement of glycaemic control and treatment satisfaction by switching from liraglutide or dulaglutide to subcutaneous semaglutide in patients with type 2 diabetes: A multicentre, prospective, randomized, open-label, parallel-group comparison study (SWITCH-SEMA 1 study).

机构信息

Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.

Jiyugaoka Medical Clinic, Obihiro, Japan.

出版信息

Diabetes Obes Metab. 2023 Jun;25(6):1503-1511. doi: 10.1111/dom.14998. Epub 2023 Feb 28.

Abstract

AIM

To investigate the effects of switching from liraglutide or dulaglutide to once-weekly semaglutide on glycaemic control and treatment satisfaction in patients with type 2 diabetes.

MATERIALS AND METHODS

In this multicentre, open-labelled, prospective, randomized, parallel-group comparison study, patients treated with liraglutide 0.9-1.8 mg/day (plan A) or dulaglutide 0.75 mg/week (plan B) were either switched to semaglutide or continued current therapy. The primary endpoint was the mean change in glycated haemoglobin over 24 weeks. The secondary endpoints included the changes of Diabetes Treatment Satisfaction Questionnaire scores, body weight and metabolic indices.

RESULTS

In total, 110 patients were enrolled, and 10 were excluded; therefore, 37 patients in plan A and 63 patients in plan B completed the study. Glycated haemoglobin levels were significantly reduced in the semaglutide group in both plans [plan A, 7.8% ± 1.0% to 7.8% ± 0.7% (liraglutide) vs. 7.9% ± 0.7% to 7.3% ± 0.7% (semaglutide), p < .01; plan B, 7.8% ± 1.0% to 7.9% ± 1.2% (dulaglutide) vs. 7.8% ± 0.8% to 7.1% ± 0.6% (semaglutide), p < .01]. Semaglutide also improved Diabetes Treatment Satisfaction Questionnaire scores in both groups (plan A, +0.1 vs. +8.3, p < .01; plan B, -1.2 vs. +3.5, p < .01). Switching from dulaglutide yielded greater reductions in body weight and improved metabolic parameters.

CONCLUSIONS

Once-weekly semaglutide administration improved glycaemic control and treatment satisfaction after switching from liraglutide or dulaglutide. These results highlighted a useful treatment option for patients with metabolic abnormalities despite glucagon-like receptor-1 receptor agonist treatment.

摘要

目的

研究将利拉鲁肽或度拉鲁肽转换为每周一次的司美格鲁肽对 2 型糖尿病患者血糖控制和治疗满意度的影响。

材料和方法

在这项多中心、开放标签、前瞻性、随机、平行组比较研究中,接受利拉鲁肽 0.9-1.8mg/天(方案 A)或度拉鲁肽 0.75mg/周(方案 B)治疗的患者被转换为司美格鲁肽或继续当前治疗。主要终点是 24 周时糖化血红蛋白的平均变化。次要终点包括糖尿病治疗满意度问卷评分、体重和代谢指标的变化。

结果

共有 110 名患者入组,10 名患者被排除;因此,方案 A 中有 37 名患者,方案 B 中有 63 名患者完成了研究。在两个方案中,司美格鲁肽组的糖化血红蛋白水平均显著降低[方案 A,7.8%±1.0%至 7.8%±0.7%(利拉鲁肽)与 7.3%±0.7%(司美格鲁肽),p<.01;方案 B,7.8%±1.0%至 7.9%±1.2%(度拉鲁肽)与 7.8%±0.8%至 7.1%±0.6%(司美格鲁肽),p<.01]。司美格鲁肽也改善了两组患者的糖尿病治疗满意度问卷评分(方案 A,+0.1 与+8.3,p<.01;方案 B,-1.2 与+3.5,p<.01)。从度拉鲁肽转换为司美格鲁肽可使体重减轻更多,并改善代谢参数。

结论

每周一次的司美格鲁肽给药可改善利拉鲁肽或度拉鲁肽转换后的血糖控制和治疗满意度。这些结果强调了一种有用的治疗选择,适用于尽管使用胰高血糖素样肽-1 受体激动剂治疗仍存在代谢异常的患者。

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