Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Department of Endocrinology and Metabolism, Nowon Eulji Medical Center, Eulji University, Seoul, Korea.
Endocrinol Metab (Seoul). 2023 Jun;38(3):328-337. doi: 10.3803/EnM.2023.1688. Epub 2023 Jun 28.
This study evaluated the efficacy and safety of add-on gemigliptin in patients with type 2 diabetes mellitus (T2DM) who had inadequate glycemic control with metformin and dapagliflozin.
In this randomized, placebo-controlled, parallel-group, double-blind, phase III study, 315 patients were randomized to receive either gemigliptin 50 mg (n=159) or placebo (n=156) with metformin and dapagliflozin for 24 weeks. After the 24-week treatment, patients who received the placebo were switched to gemigliptin, and all patients were treated with gemigliptin for an additional 28 weeks.
The baseline characteristics were similar between the two groups, except for body mass index. At week 24, the least squares mean difference (standard error) in hemoglobin A1c (HbA1c) changes was -0.66% (0.07) with a 95% confidence interval of -0.80% to -0.52%, demonstrating superior HbA1c reduction in the gemigliptin group. After week 24, the HbA1c level significantly decreased in the placebo group as gemigliptin was administered, whereas the efficacy of HbA1c reduction was maintained up to week 52 in the gemigliptin group. The safety profiles were similar: the incidence rates of treatment-emergent adverse events up to week 24 were 27.67% and 29.22% in the gemigliptin and placebo groups, respectively. The safety profiles after week 24 were similar to those up to week 24 in both groups, and no new safety findings, including hypoglycemia, were noted.
Add-on gemigliptin was well tolerated, providing comparable safety profiles and superior efficacy in glycemic control over placebo for long-term use in patients with T2DM who had poor glycemic control with metformin and dapagliflozin.
本研究评估了二甲双胍和达格列净血糖控制不佳的 2 型糖尿病(T2DM)患者加用 gemigliptin 的疗效和安全性。
在这项随机、安慰剂对照、平行分组、双盲、III 期研究中,315 例患者随机分为 gemigliptin 50mg 组(n=159)或安慰剂组(n=156),与二甲双胍和达格列净联合治疗 24 周。24 周治疗后,安慰剂组患者换用 gemigliptin,所有患者再接受 gemigliptin 治疗 28 周。
两组患者的基线特征相似,除了体重指数。在 24 周时,血红蛋白 A1c(HbA1c)变化的最小二乘均数(标准误差)差值为-0.66%(0.07),95%置信区间为-0.80%至-0.52%,表明 gemigliptin 组 HbA1c 降低更显著。在 24 周后,随着 gemigliptin 的给药,安慰剂组的 HbA1c 水平显著下降,而 gemigliptin 组的 HbA1c 降低疗效维持至 52 周。安全性谱相似:至 24 周时,gemigliptin 组和安慰剂组治疗中出现的不良事件发生率分别为 27.67%和 29.22%。在两组中,24 周后安全性谱与 24 周前相似,未发现新的安全性发现,包括低血糖。
加用 gemigliptin 耐受性良好,在长期使用二甲双胍和达格列净血糖控制不佳的 T2DM 患者中,与安慰剂相比,提供了相似的安全性谱和血糖控制的优越疗效。