在接受替尔泊肽治疗的2型糖尿病患者中，血糖和体重管理的改善与生活质量的提高相关。
Improved Glycaemic and Weight Management Are Associated with Better Quality of Life in People with Type 2 Diabetes Treated with Tirzepatide.
作者信息
Boye Kristina S, Sapin Hélène, Dong Wenxiu, Williamson Suzanne, Lee Clare J, Thieu Vivian Thuyanh
机构信息
Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, 46285, USA.
TechData Service Company, King of Prussia, PA, USA.
出版信息
Diabetes Ther. 2023 Nov;14(11):1867-1887. doi: 10.1007/s13300-023-01457-7. Epub 2023 Sep 5.
INTRODUCTION
Limited data are available on the relationship between quality of life (QoL) change and significant degrees of reduction in glycated haemoglobin (HbA1c) and/or weight loss in people with type 2 diabetes (T2D). We explored the associations between HbA1c targets and/or weight loss achieved and patient-reported outcomes (PROs) in adults with T2D treated with tirzepatide, a first-in-class once weekly glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptor agonist, using pooled data from SURPASS-1 to -5 Phase 3 clinical trials.
METHODS
PROs were assessed using five instruments at baseline and endpoint (Week 40 in SURPASS-1, -2 and -5; Week 52 in SURPASS-3 and -4): Impact of Weight on Quality of Life-Lite Clinical Trials Version; Impact of Weight on Self-Perception (IW-SP) questionnaire; Ability to Perform Physical Activities of Daily Living (APPADL); Diabetes Treatment Satisfaction Questionnaire change; and EQ-5D-5L. All PROs were assessed in participants receiving pooled doses of tirzepatide (5, 10 or 15 mg) and achieving HbA1c targets of < 5.7%, ≥ 5.7-≤ 6.5% and > 6.5% or achieving ≥ 0-< 5%, ≥ 5-< 10%, ≥ 10-< 15% and ≥ 15% weight loss from baseline at endpoint. The APPADL, IW-SP and EQ visual analogue scores were evaluated in participants achieving each combination of HbA1c target and weight loss.
RESULTS
Achievement of lower HbA1c targets or higher body weight percentage losses were each associated with greater improvements in QoL than achievement of higher HbA1c targets or lower body weight percentage losses, respectively. Achievement of lower HbA1c targets in combination with greater weight loss was generally associated with the best QoL ratings.
CONCLUSIONS
Our findings demonstrate that HbA1c targets and significant percentage body weight reduction thresholds need to be achieved for people with T2D to help substantially increase their overall health-related QoL. Tirzepatide treatment may allow a high proportion of people with T2D to achieve these targets, enabling improved QoL.
CLINICAL TRIAL REGISTRATION
SURPASS-1: NCT03954834; SURPASS-2: NCT03987919; SURPASS-3: NCT03882970; SURPASS-4: NCT03730662; SURPASS-5: NCT04039503.
简介
关于2型糖尿病（T2D）患者生活质量（QoL）变化与糖化血红蛋白（HbA1c）显著降低和/或体重减轻之间的关系，现有数据有限。我们使用SURPASS-1至-5期3临床试验的汇总数据，探讨了接受替尔泊肽治疗的成年T2D患者实现的HbA1c目标和/或体重减轻与患者报告结局（PROs）之间的关联。替尔泊肽是一种一流的每周一次葡萄糖依赖性促胰岛素多肽和胰高血糖素样肽-1受体激动剂。
方法
在基线和终点（SURPASS-1、-2和-5中为第40周；SURPASS-3和-4中为第52周）使用五种工具评估PROs：《生活质量-简化版临床试验问卷》；体重对自我认知的影响（IW-SP）问卷；进行日常生活身体活动的能力（APPADL）；糖尿病治疗满意度问卷变化；以及EQ-5D-5L。在接受替尔泊肽合并剂量（5、10或15毫克）并实现HbA1c目标<5.7%、≥5.7%至≤6.5%和>6.5%或在终点时体重较基线减轻≥0%至<5%、≥5%至<10%、≥10%至<15%和≥15%的参与者中评估所有PROs。在实现HbA1c目标和体重减轻每种组合的参与者中评估APPADL、IW-SP和EQ视觉模拟评分。
结果
与分别实现较高的HbA1c目标或较低的体重减轻百分比相比，实现较低的HbA1c目标或较高的体重减轻百分比分别与QoL的更大改善相关。实现较低的HbA1c目标并同时实现更大的体重减轻通常与最佳的QoL评分相关。
结论
我们的研究结果表明，T2D患者需要实现HbA1c目标和显著的体重减轻百分比阈值，以大幅提高其整体健康相关的QoL。替尔泊肽治疗可能使很大一部分T2D患者实现这些目标，从而改善QoL。
临床试验注册
SURPASS-1：NCT03954834；SURPASS-2：NCT03987919；SURPASS-3：NCT03882970；SURPASS-4：NCT03730662；SURPASS-5：NCT04039503。
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