Department of Pharmacy, Emory HealthCare, Atlanta, GA, USA.
Department of Pharmacy, University of Rochester Medical Center, Rochester, NY, USA.
Ann Pharmacother. 2024 Jun;58(6):589-597. doi: 10.1177/10600280231199852. Epub 2023 Sep 24.
Limited real-world data on the benefits and risks associated with 3 and 4.5 mg doses of dulaglutide currently exists, making it difficult to determine the impact of dose titration for patients currently managed with dulaglutide 1.5 mg weekly.
To determine the impact of dulaglutide 3 and 4.5 mg doses on weight and hemoglobin A1c (HbA1c) in patients with type 2 diabetes mellitus (T2DM), in clinical practice.
Retrospective, observational study of adult T2DM patients receiving dulaglutide 3 or 4.5 mg weekly within a large, university-affiliated, primary care network. The primary outcome was change in weight and HbA1c from baseline to 24 weeks. Secondary outcomes included incremental changes in weight and HbA1c, and describing trends related to dose reductions.
Ninety-five patients were included, 62 in the dulaglutide 3 mg group and 33 in the dulaglutide 4.5 mg group. After 24 weeks, the mean changes in weight and HbA1c from baseline were -1.8 kg ( < 0.01) and -0.4% ( < 0.01) in the 3 mg group, and -4.2 kg ( < 0.01) and -0.4% ( = 0.119) in the 4.5 mg group. Incremental change in weight and HbA1c among patients who were titrated from dulaglutide 3 to 4.5 mg weekly were -2.6 kg ( < 0.01) and -0.2% ( = 0.04), respectively.
Titration from dulaglutide 1.5 to 3 mg resulted in significant reductions in weight and HbA1c after 24 weeks. Additional, statistically significant, reductions in weight and HbA1c were seen when patients were further titrated to dulaglutide 4.5 mg weekly.
目前关于利拉鲁肽 3mg 和 4.5mg 剂量的获益和风险的真实世界数据有限，这使得难以确定对于目前接受每周 1.5mg 利拉鲁肽治疗的患者进行剂量滴定的影响。
在临床实践中，确定利拉鲁肽 3mg 和 4.5mg 剂量对 2 型糖尿病（T2DM）患者的体重和糖化血红蛋白（HbA1c）的影响。
这是一项回顾性、观察性研究，纳入了在一个大型的、大学附属的初级保健网络中接受每周 3mg 或 4.5mg 利拉鲁肽治疗的成年 T2DM 患者。主要结局是从基线到 24 周时体重和 HbA1c 的变化。次要结局包括体重和 HbA1c 的增量变化，并描述与剂量减少相关的趋势。
共纳入 95 例患者，其中 62 例在利拉鲁肽 3mg 组，33 例在利拉鲁肽 4.5mg 组。24 周后，从基线到 24 周时，3mg 组体重和 HbA1c 的平均变化分别为-1.8kg（<0.01）和-0.4%（<0.01），4.5mg 组分别为-4.2kg（<0.01）和-0.4%（=0.119）。从每周 3mg 利拉鲁肽滴定至每周 4.5mg 利拉鲁肽的患者体重和 HbA1c 的增量变化分别为-2.6kg（<0.01）和-0.2%（=0.04）。
从利拉鲁肽 1.5mg 滴定至 3mg 后 24 周体重和 HbA1c 显著降低。当患者进一步滴定至每周 4.5mg 利拉鲁肽时，体重和 HbA1c 出现了额外的、具有统计学意义的降低。
