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胰高血糖素样肽-1 受体激动剂在 2 型糖尿病患者中的疗效和安全性:一项回顾性真实世界研究的证据。

Effectiveness and safety of glucagon-like peptide 1 receptor agonists in patients with type 2 diabetes: evidence from a retrospective real-world study.

机构信息

Department of Pharmacy, The Second Affiliated Hospital of Dalian Medical University, Dalian, China.

出版信息

Front Endocrinol (Lausanne). 2024 Mar 8;15:1347684. doi: 10.3389/fendo.2024.1347684. eCollection 2024.

DOI:10.3389/fendo.2024.1347684
PMID:38524632
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10958196/
Abstract

INTRODUCTION

Global phase III clinical trials have shown superior hypoglycemic efficacy to insulin and other oral hypoglycemic agents. However, there is a scarcity of real-world data comparing different glucagon-like peptide 1 receptor agonist (GLP-1RA) directly. This study aimed to assess the safety and effectiveness of various GLP-1RA in treating type 2 diabetes mellitus (T2DM) in a real-world clinical setting and identify predictive factors for favorable treatment outcomes.

METHODS

This was a retrospective, single-center, real-world study. The changes in HbA1c, fasting plasma glucose (FPG), body weight, systolic blood pressure (SBP), diastolic blood pressure (DBP), and the percentage of participants who achieved HbA1c of <7%, 7%-8%, and ≥ 8% after GLP-1RA treatment was analyzed. The clinical factors that affect the effectiveness of GLP-1RA were analyzed.

RESULTS

At baseline, the 249 participants had a mean baseline HbA1c of 8.7 ± 1.1%. After at least three months of follow-up, the change in HbA1c was -0.89 ± 1.3% from baseline. Dulaglutide exerted a more significant hypoglycemic effect than immediate-release exenatide. The percentage of participants who achieved HbA1c<7% was substantial, from 6.0% at baseline to 28.9%. Average body weight decreased by 2.02 ± 3.8 kg compared to baseline. After GLP-1RA treatment, the reduction in SBP was 2.4 ± 7.1 mmHg from baseline. A shorter duration of diabetes and a higher baseline HbA1c level were more likely to achieve a good response in blood glucose reduction.

CONCLUSIONS

This study provided real-world evidence showing that GLP-1RA significantly improved HbA1c, body weight, and SBP. The results can inform the decision-making about GLP-1RA treatment in daily clinical practice.

摘要

简介

全球三期临床试验表明,胰高血糖素样肽 1 受体激动剂(GLP-1RA)在降血糖方面优于胰岛素和其他口服降糖药。然而,直接比较不同 GLP-1RA 的真实世界数据却很少。本研究旨在评估 GLP-1RA 在真实临床环境中治疗 2 型糖尿病(T2DM)的安全性和有效性,并确定预测良好治疗效果的因素。

方法

这是一项回顾性、单中心、真实世界的研究。分析了 GLP-1RA 治疗后 HbA1c、空腹血糖(FPG)、体重、收缩压(SBP)、舒张压(DBP)的变化以及达到 HbA1c<7%、7%-8%和≥8%的参与者比例。分析了影响 GLP-1RA 疗效的临床因素。

结果

在基线时,249 名参与者的平均基线 HbA1c 为 8.7±1.1%。经过至少三个月的随访,HbA1c 从基线水平下降了-0.89±1.3%。度拉鲁肽比短效艾塞那肽具有更显著的降血糖作用。达到 HbA1c<7%的参与者比例很高,从基线时的 6.0%上升到 28.9%。平均体重与基线相比下降了 2.02±3.8kg。与基线相比,GLP-1RA 治疗后 SBP 降低了 2.4±7.1mmHg。糖尿病病程较短和基线 HbA1c 水平较高者更有可能在血糖降低方面获得良好反应。

结论

本研究提供了真实世界的证据,表明 GLP-1RA 显著改善了 HbA1c、体重和 SBP。结果可以为日常临床实践中 GLP-1RA 治疗的决策提供信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/92ef/10958196/c2822c6e3c57/fendo-15-1347684-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/92ef/10958196/c2822c6e3c57/fendo-15-1347684-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/92ef/10958196/c2822c6e3c57/fendo-15-1347684-g001.jpg

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