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真实世界中评估替西帕肽在 2 型糖尿病患者中的疗效。

Real-world evaluation of the effects of tirzepatide in patients with type 2 diabetes mellitus.

机构信息

Thomas Jefferson College of Pharmacy, Philadelphia, Pennsylvania, USA.

Internal Medicine Associates, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.

出版信息

Diabetes Obes Metab. 2024 Dec;26(12):5661-5668. doi: 10.1111/dom.15934. Epub 2024 Sep 9.

Abstract

AIMS

Tirzepatide is a first-in-class combination glucose-dependent insulinotropic polypeptide (GIP) receptor agonist and glucagon-like peptide 1 receptor agonist (GLP1-RA) approved for treatment of adults with type 2 diabetes mellitus (T2DM) and chronic weight management. The aim of this analysis was to assess the real-world efficacy of tirzepatide in patients with T2DM.

METHODS

This retrospective observational study evaluated patients with T2DM from a large urban academic medical centre who received at least 3 months of continuous tirzepatide treatment. The primary outcome was change in A1C from following tirzepatide treatment. Secondary outcomes included change in body weight and body mass index (BMI) after tirzepatide was initiated.

RESULTS

A total of 1896 patient charts were reviewed, and 612 patients were evaluated for the primary outcome. Over a median time period of 10.4 months, treatment with tirzepatide resulted in a mean A1C reduction of 1.02 ± 1.48% (p < 0.001). A total of 570 patients were evaluated for the secondary outcomes. Tirzepatide was associated with a mean reduction in body weight of 7.3 ± 9.3 kg (p < 0.001) and a mean reduction in BMI of 2.5 kg/m. Greater A1C lowering and weight loss was observed in patients without prior GLP1-RA treatment compared to those switched to tirzepatide from GLP1-RA.

CONCLUSIONS

In a real-world population of US patients with T2DM, tirzepatide was associated with clinically and statistically significant reductions in A1C and body weight. Greater reductions in both A1C and body weight were observed among patients who were GLP1-RA naïve compared to patients switched from GLP1-RA to tirzepatide.

摘要

目的

替尔泊肽是一种新型的葡萄糖依赖性胰岛素促泌多肽(GIP)受体激动剂和胰高血糖素样肽 1 受体激动剂(GLP1-RA),已被批准用于治疗 2 型糖尿病(T2DM)成人患者和慢性体重管理。本分析的目的是评估替尔泊肽在 T2DM 患者中的真实世界疗效。

方法

本回顾性观察性研究评估了来自一家大型城市学术医疗中心的接受至少 3 个月连续替尔泊肽治疗的 T2DM 患者。主要结局是接受替尔泊肽治疗后 A1C 的变化。次要结局包括起始替尔泊肽治疗后体重和体重指数(BMI)的变化。

结果

共回顾了 1896 份患者病历,其中 612 例患者评估了主要结局。在中位时间为 10.4 个月的治疗期间,替尔泊肽治疗导致 A1C 平均降低 1.02±1.48%(p<0.001)。共评估了 570 例患者的次要结局。替尔泊肽与体重平均降低 7.3±9.3kg(p<0.001)和 BMI 平均降低 2.5kg/m 相关。与从 GLP1-RA 转为替尔泊肽的患者相比,未接受过 GLP1-RA 治疗的患者观察到更大的 A1C 降低和体重减轻。

结论

在一项美国 T2DM 真实世界患者人群中,替尔泊肽与 A1C 和体重的显著临床和统计学降低相关。与从 GLP1-RA 转为替尔泊肽的患者相比,GLP1-RA 初治患者观察到 A1C 和体重降低幅度更大。

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