Lilly Centre for Clinical Pharmacology Pte Ltd, Singapore.
Eli Lilly and Company, Indianapolis, Indiana, USA.
Diabetes Obes Metab. 2023 Sep;25(9):2642-2649. doi: 10.1111/dom.15150. Epub 2023 Jun 1.
AIM: To report the results of a Phase 1b trial evaluating the safety, pharmacokinetics and pharmacodynamics of orforglipron (LY3502970), an oral, non-peptide glucagon-like peptide-1 receptor agonist (GLP-1RA), in patients with type 2 diabetes (T2D). MATERIALS AND METHODS: This was a double-blind, placebo-controlled Phase 1 study evaluating five different dosing regimens. The first group established that weekly dose escalation of the daily doses of orforglipron was generally well tolerated. This enabled a parallel-arm design for the four groups following. Participants were randomized 3:1 to daily doses of orforglipron or placebo for 12 weeks. Eligible participants with T2D were aged 18 to 70 years and had glycated haemoglobin (HbA1c) levels ≥53.0 mmol/mol (7.0%) and ≤91.3 mmol/mol (10.5%). RESULTS: A total of 51 participants received orforglipron and 17 received placebo. In the placebo and orforglipron groups, respectively, baseline HbA1c was 8.1% and 8.0%, and baseline body weight was 90.3 and 88.4 kg. The most common adverse events were gastrointestinal-related, and occurred early in treatment, similar to findings with other GLP-1RAs. At Week 12, mean t ranged from 29 to 49 hours. Mean HbA1c change ranged from -1.5% to -1.8% across orforglipron doses, versus -0.4% with placebo, and body weight change was -0.24 to -5.8 kg across orforglipron doses, versus 0.5 kg with placebo. CONCLUSIONS: Orforglipron treatment resulted in meaningful reductions in HbA1c and body weight, with an adverse event profile consistent with that of other GLP-1RAs. Orforglipron may provide a safe and effective once-daily oral treatment alternative to injectable GLP-1RAs or peptide oral formulations without water and food restrictions.
目的:报告评估口服非肽类胰高血糖素样肽-1 受体激动剂(GLP-1RA)奥福格鲁匹隆(LY3502970)在 2 型糖尿病(T2D)患者中的安全性、药代动力学和药效学的 1b 期试验结果。
材料和方法:这是一项双盲、安慰剂对照的 1 期研究,评估了五种不同的给药方案。第一组确定,奥福格鲁匹隆的每日剂量递增每周剂量递增通常具有良好的耐受性。这使得后续的四组能够采用平行臂设计。参与者按 3:1 的比例随机分配接受奥福格鲁匹隆或安慰剂每日剂量治疗 12 周。符合条件的 T2D 参与者年龄在 18 至 70 岁之间,糖化血红蛋白(HbA1c)水平≥53.0mmol/mol(7.0%)且≤91.3mmol/mol(10.5%)。
结果:共有 51 名参与者接受了奥福格鲁匹隆治疗,17 名参与者接受了安慰剂治疗。安慰剂和奥福格鲁匹隆组的基线 HbA1c 分别为 8.1%和 8.0%,基线体重分别为 90.3kg 和 88.4kg。最常见的不良事件是胃肠道相关的,并且发生在治疗早期,与其他 GLP-1RA 的发现相似。在第 12 周时,平均 t 范围为 29 至 49 小时。奥福格鲁匹隆剂量组的平均 HbA1c 变化范围为-1.5%至-1.8%,安慰剂组为-0.4%,奥福格鲁匹隆剂量组的体重变化范围为-0.24 至-5.8kg,安慰剂组为 0.5kg。
结论:奥福格鲁匹隆治疗可显著降低 HbA1c 和体重,其不良事件谱与其他 GLP-1RA 一致。奥福格鲁匹隆可能为每日一次的口服治疗提供了一种安全有效的替代方案,适用于不能接受注射用 GLP-1RA 或肽口服制剂的患者,且没有水和食物限制。
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