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2型糖尿病患者中每周一次奥格列汀与每日一次二肽基肽酶-4抑制剂的治疗负担:随机对照试验(ONWARD-DPP4研究)

Treatment Burden on Once-Weekly Omarigliptin Versus Daily Dipeptidyl Peptidase-4 Inhibitors in Patients with Type 2 Diabetes: Randomized Controlled Trial (ONWARD-DPP4 Study).

作者信息

Ishii Hitoshi, Kamei Nozomu, Shimono Dai, Niiya Tetsuji, Tosaki Takahiro, Kitazawa Toru, Suzuki Daisuke, Wakasa Yutaka, Seino Hiroaki, Oishi Mariko, Ohashi Hiroshi, Higami Kenshi, Akai Hiroaki

机构信息

Department of Doctor-Patient Relationships, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8521, Japan.

Department of Endocrinology and Metabolism, Hiroshima Red Cross Hospital and Atomic-Bomb Survivors Hospital, Hiroshima, Hiroshima, Japan.

出版信息

Diabetes Ther. 2023 Oct;14(10):1639-1658. doi: 10.1007/s13300-023-01442-0. Epub 2023 Jul 19.

Abstract

INTRODUCTION

Preference for quality of life is important in deciding the treatment strategy for patients with type 2 diabetes mellitus. This study aimed to assess the effect of omarigliptin on patients' psychological attitudes and responses compared with daily dipeptidyl peptidase-4 inhibitors (DPP4is) by measuring the burden of pharmacotherapy using the Diabetic Treatment Burden Questionnaire (DTBQ).

METHODS

Patients with type 2 diabetes mellitus who were taking daily DPP-4is were enrolled and randomized to a group that switched to omarigliptin or a group that continued daily DPP4is and were monitored for 12 weeks. The primary endpoint was the change in the DTBQ score from baseline to week 12. The secondary endpoints included changes in blood test results, medication preferences and medication adherence.

RESULTS

The DTBQ total score significantly decreased from baseline to week 12 in both groups; however, no significant intergroup differences were observed. The DTBQ subscale, implementation and flexibility burden scores significantly decreased in the group that switched to omarigliptin, although no significant intergroup difference in the change was observed. DTBQ scores and medication preferences were associated with improvements in the DTBQ scores.

CONCLUSION

Although this study failed to demonstrate the improvement of DTBQ total score by switching from daily DPP4is to omarigliptin compared with continuing the daily DPP4is, the DTBQ subscale score implementation and flexibility burden score were significantly improved only in the group that switched to omarigliptin, suggesting the possibility of switching from daily DPP4is to omarigliptin to decrease the patients' medication burden.

TRIAL REGISTRATION

jRCTs031200437.

摘要

引言

生活质量偏好对于决定2型糖尿病患者的治疗策略至关重要。本研究旨在通过使用糖尿病治疗负担问卷(DTBQ)测量药物治疗负担,评估奥格列汀与每日二肽基肽酶-4抑制剂(DPP4i)相比对患者心理态度和反应的影响。

方法

纳入正在服用每日DPP-4i的2型糖尿病患者,并将其随机分为转为使用奥格列汀的组或继续使用每日DPP4i的组,进行为期12周的监测。主要终点是从基线到第12周DTBQ评分的变化。次要终点包括血液检测结果、用药偏好和用药依从性的变化。

结果

两组的DTBQ总分从基线到第12周均显著降低;然而,未观察到显著的组间差异。转为使用奥格列汀的组中,DTBQ子量表、实施和灵活性负担评分显著降低,尽管在变化方面未观察到显著的组间差异。DTBQ评分和用药偏好与DTBQ评分的改善相关。

结论

尽管本研究未能证明与继续使用每日DPP4i相比,从每日DPP4i转为使用奥格列汀可改善DTBQ总分,但仅在转为使用奥格列汀的组中,DTBQ子量表评分、实施和灵活性负担评分显著改善,这表明从每日DPP4i转为使用奥格列汀有可能减轻患者的用药负担。

试验注册

jRCTs031200437。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ee02/10499707/17e45b5894bd/13300_2023_1442_Fig1_HTML.jpg

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