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恩格列净联合胰岛素治疗血糖控制不佳的中国 2 型糖尿病患者的疗效和安全性:一项 III 期、随机、双盲、安慰剂对照、平行研究。

Efficacy and safety of empagliflozin in combination with insulin in Chinese patients with type 2 diabetes and insufficient glycaemic control: A phase III, randomized, double-blind, placebo-controlled, parallel study.

机构信息

Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, People's Republic of China.

Department of Endocrinology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, People's Republic of China.

出版信息

Diabetes Obes Metab. 2023 Jul;25(7):1839-1848. doi: 10.1111/dom.15041. Epub 2023 Mar 23.

Abstract

AIM

To evaluate the efficacy and safety of empagliflozin in combination with insulin ± oral antidiabetic drugs (OADs) over 24 weeks, in Chinese patients with type 2 diabetes (T2D) who had insufficient glycaemic control.

MATERIALS AND METHODS

This was a randomized, double-blind, placebo-controlled, parallel group, multicentre phase III study. Adult patients with T2D and insufficient glycaemic control who received insulin ± up to two OADs were randomized (1:1:1) to receive empagliflozin 10 or 25 mg, or placebo for 24 weeks. The primary endpoint was change from baseline in HbA1c at week 24.

RESULTS

Of 219 randomized patients, 73 patients were in each treatment group; baseline characteristics were comparable among the groups. There was a significantly larger decrease from baseline in HbA1c (adjusted mean treatment difference -0.99 and -0.98 for in the empagliflozin 10 and 25 mg groups, respectively; P < .0001) with both doses of empagliflozin than with placebo. There were also significantly larger decreases from baseline in fasting plasma glucose, 2-hour postprandial glucose and body weight with both empagliflozin doses than with placebo. Among patients in the empagliflozin 10 mg, 25 mg and placebo groups, 17.8%, 9.6% and 11.0% reported confirmed hypoglycaemic events, respectively (nominal P = .2422 and .7661 in the empagliflozin 10 and 25 mg groups, respectively), and no Clinical Events Committee-confirmed diabetic ketoacidosis events were reported.

CONCLUSIONS

In Chinese patients with T2D, empagliflozin combined with insulin ± OADs improved glycaemic control and was well tolerated, without an increased risk of hypoglycaemia.

摘要

目的

评估恩格列净联合胰岛素±口服降糖药(OADs)治疗 24 周对血糖控制不佳的中国 2 型糖尿病(T2D)患者的疗效和安全性。

材料和方法

这是一项随机、双盲、安慰剂对照、平行分组、多中心 III 期研究。接受胰岛素±两种 OADs 治疗且血糖控制不佳的成年 T2D 患者按 1:1:1 的比例随机(随机分组)接受恩格列净 10mg 或 25mg 或安慰剂治疗 24 周。主要终点为 24 周时 HbA1c 自基线的变化。

结果

219 例随机患者中,每组 73 例;各组基线特征相似。与安慰剂组相比,恩格列净 10mg 和 25mg 组 HbA1c 自基线的下降幅度均显著更大(调整后的平均治疗差异分别为-0.99 和-0.98;P<0.0001)。与安慰剂组相比,恩格列净 10mg 和 25mg 组空腹血糖、餐后 2 小时血糖和体重自基线的下降幅度也显著更大。恩格列净 10mg、25mg 和安慰剂组中分别有 17.8%、9.6%和 11.0%的患者报告了确诊的低血糖事件(恩格列净 10mg 和 25mg 组的名义 P 值分别为.2422 和.7661),且均未报告临床事件委员会确认的糖尿病酮症酸中毒事件。

结论

在中国 T2D 患者中,恩格列净联合胰岛素±OADs 可改善血糖控制,且耐受性良好,低血糖风险无增加。

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