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恩格列净对比达格列净加用二甲双胍和西格列汀治疗 2 型糖尿病患者的疗效和安全性:一项双盲、随机、活性药物对照研究:ENHANCE-D 研究。

Efficacy and safety of enavogliflozin versus dapagliflozin added to metformin plus gemigliptin treatment in patients with type 2 diabetes: A double-blind, randomized, comparator-active study: ENHANCE-D study.

机构信息

Department of Internal Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea.

Department of Internal Medicine, Nowon Eulji Medical Center, Eulji University, Seoul, Republic of Korea.

出版信息

Diabetes Metab. 2023 Jul;49(4):101440. doi: 10.1016/j.diabet.2023.101440. Epub 2023 Mar 9.

Abstract

AIMS

This study evaluated the efficacy and safety of enavogliflozin, a novel sodium-glucose cotransporter 2 inhibitor, versus dapagliflozin in Korean patients with type 2 diabetes mellitus (T2DM) inadequately controlled with metformin and gemigliptin.

METHODS

In this multicenter, double-blind, randomized study, patients with inadequate response to metformin (≥ 1000 mg/day) plus gemigliptin (50 mg/day) were randomized to receive enavogliflozin 0.3 mg/day (n = 134) or dapagliflozin 10 mg/day (n = 136) in addition to the metformin plus gemigliptin therapy. The primary endpoint was change in HbA1c from baseline to week 24.

RESULTS

Both treatments significantly reduced HbA1c at week 24 (-0.92% in enavogliflozin group, -0.86% in dapagliflozin group). The enavogliflozin and dapagliflozin groups did not differ in terms of changes in HbA1c (between-group difference: -0.06%, 95% confidence interval [CI]: -0.19, 0.06) and fasting plasma glucose (between-group difference: -3.49 mg/dl [-8.08;1.10]). An increase in urine glucose-creatinine ratio was significantly greater in the enavogliflozin group than in the dapagliflozin group (60.2 g/g versus 43.5 g/g, P < 0.0001). The incidence of treatment-emergent adverse events was similar between the groups (21.64% versus 23.53%).

CONCLUSIONS

Enavogliflozin, added to metformin plus gemigliptin, was well tolerated and as effective as dapagliflozin in the treatment of patients with T2DM.

摘要

目的

本研究旨在评估新型钠-葡萄糖共转运蛋白 2(SGLT2)抑制剂恩格列净在二甲双胍和吉美嘧啶治疗控制不佳的韩国 2 型糖尿病(T2DM)患者中的疗效和安全性。

方法

在这项多中心、双盲、随机研究中,二甲双胍(≥1000mg/天)加吉美嘧啶(50mg/天)治疗反应不佳的患者被随机分为恩格列净 0.3mg/天(n=134)或达格列净 10mg/天(n=136)组,两组均在原治疗基础上添加治疗。主要终点为治疗 24 周时 HbA1c 的变化。

结果

两种治疗均显著降低了 HbA1c(恩格列净组下降 0.92%,达格列净组下降 0.86%)。恩格列净组和达格列净组在 HbA1c 变化(两组间差值:-0.06%,95%置信区间[CI]:-0.19,0.06)和空腹血糖(两组间差值:-3.49mg/dl[-8.08;1.10])方面无差异。与达格列净组相比,恩格列净组的尿糖/肌酐比值显著升高(60.2g/g 比 43.5g/g,P<0.0001)。两组治疗期间不良事件的发生率相似(21.64%比 23.53%)。

结论

恩格列净联合二甲双胍和吉美嘧啶治疗 T2DM 患者耐受性良好,与达格列净疗效相当。

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