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固定剂量复方制剂(基础胰岛素+ GLP-1RA)在 2 型糖尿病中的应用:关键性临床试验的分析评价。

Fixed-ratio Combinations (basal Insulin Plus GLP-1RA) In Type 2 Diabetes. an Analytical Review Of Pivotal Clinical Trials.

机构信息

Metabolic Diseases Study Group, Department of Internal Medicine, Universidad del Cauca, Popayán-Colombia.

National Research Institute, USA.

出版信息

Rev Diabet Stud. 2023 Mar 31;19(1):14-27. doi: 10.1900/RDS.2023.19.14.

Abstract

In type 2 diabetes, therapeutic failure to the oral anti diabetics is frequent, the use of schemes with basal insulin or with multiple doses of insulin (basal insulin and short-acting insulins) are a widely accepted way to intensify therapy. The use of GLP-1 receptor agonists is another intensification strategy. The fixedratio combinations with molecules such as insulin degludec + liraglutide, and insulin glargine + lixisenatide have proven useful in intensifying treatment of individuals with type 2 diabetes. The purpose of this review was to evaluate and analyze the results of pivotal studies with both fixed-ratio combinations in individuals with type 2 diabetes, finding that, they are capable of achieving better glycemic control when compared with each of its components separately (with a lower risk of hypoglycemia vs basal insulin and lower risk of gastrointestinal adverse effects vs GLP-1 receptor agonists) in various clinical scenarios, especially in individuals who do not achieve control with oral antidiabetics or who do not achieve control with basal insulin (associated with oral antidiabetics) or in those under management with GLP-1RA plus oral antidiabetics.

摘要

在 2 型糖尿病中,口服抗糖尿病药物治疗失败很常见,使用基础胰岛素或多次胰岛素(基础胰岛素和短效胰岛素)方案是强化治疗的广泛接受的方法。GLP-1 受体激动剂的使用是另一种强化策略。与胰岛素德谷胰岛素+利拉鲁肽和甘精胰岛素+利西那肽等分子的固定比例组合已被证明可有效强化 2 型糖尿病患者的治疗。本综述的目的是评估和分析这两种固定比例组合在 2 型糖尿病患者中的关键研究结果,发现与每种成分单独使用相比(低血糖风险低于基础胰岛素,胃肠道不良反应风险低于 GLP-1 受体激动剂),它们在各种临床情况下,特别是在口服抗糖尿病药物控制不佳或基础胰岛素(与口服抗糖尿病药物联合使用)或 GLP-1RA 联合口服抗糖尿病药物治疗不佳的患者中,能够更好地控制血糖。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb3c/10082333/8d9a3c3b5a3e/RDS-19-014-g001.jpg

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