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西格列汀二甲双胍片(2 周 1 次)在中国 2 型糖尿病患者中的疗效与利格列汀每日 1 次的对比:一项随机、双盲、非劣效性试验。

Cofrogliptin once every 2 weeks as add-on therapy to metformin versus daily linagliptin in patients with type 2 diabetes in China: A randomized, double-blind, non-inferiority trial.

机构信息

Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, China.

Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, China.

出版信息

Diabetes Obes Metab. 2024 Nov;26(11):5013-5024. doi: 10.1111/dom.15915. Epub 2024 Sep 23.

Abstract

AIM

We evaluated the efficacy and safety of cofrogliptin, a novel dipeptidyl peptidase-4 inhibitor taken once every 2 weeks (Q2W), compared with linagliptin (taken daily) in patients with type 2 diabetes inadequately controlled on metformin in China.

MATERIALS AND METHODS

In this phase 3 randomized, double-blind, active-controlled, multicentre study, patients were randomly assigned 1:1:1 to receive cofrogliptin 10 mg Q2W, cofrogliptin 25 mg Q2W, or linagliptin 5 mg daily, all as an add-on treatment to metformin, for 24 weeks. Eligible patients could enter an open-label extension period and receive cofrogliptin 25 mg Q2W for an additional 28 weeks. The primary endpoint was change in glycated haemoglobin from baseline to 24 weeks, with a non-inferiority margin of 0.4% for cofrogliptin versus linagliptin treatment.

RESULTS

Overall, 465 patients entered the 24-week treatment period (median age: 57.0 years). The least-squares mean (standard error) change in glycated haemoglobin from baseline to week 24 was -0.96 (0.063), -0.99 (0.064) and -1.07 (0.065) for the cofrogliptin 10 mg, cofrogliptin 25 mg and linagliptin 5 mg groups, respectively. The between-group difference met the predefined margin for non-inferiority of cofrogliptin (10 and 25 mg) versus linagliptin treatment. The incidence of common adverse events (≥5% patients) during the 24-week treatment period was similar between treatment groups. There were no serious hypoglycaemic events.

CONCLUSION

In Chinese patients with type 2 diabetes inadequately controlled on metformin, the glucose-lowering effect of cofrogliptin (Q2W) was non-inferior to linagliptin (daily), with a similar safety profile maintained over 52 weeks of treatment.

摘要

目的

我们评估了每周 2 次(Q2W)给药的新型二肽基肽酶-4 抑制剂 cofrogliptin 与每日给药的利格列汀相比,在二甲双胍控制不佳的中国 2 型糖尿病患者中的疗效和安全性。

材料和方法

在这项 3 期随机、双盲、阳性对照、多中心研究中,患者按 1:1:1 的比例随机分配,接受 cofrogliptin 10mg Q2W、cofrogliptin 25mg Q2W 或利格列汀 5mg 每日治疗,均作为二甲双胍的附加治疗,共 24 周。符合条件的患者可进入开放标签扩展期,并额外接受 28 周的 cofrogliptin 25mg Q2W 治疗。主要终点是从基线到 24 周时糖化血红蛋白的变化,cofrogliptin 与利格列汀治疗的非劣效性边界为 0.4%。

结果

总体而言,465 名患者进入了 24 周的治疗期(中位年龄:57.0 岁)。从基线到第 24 周时,糖化血红蛋白的最小二乘均值(标准误差)变化分别为 cofrogliptin 10mg、cofrogliptin 25mg 和利格列汀 5mg 组的-0.96(0.063)、-0.99(0.064)和-1.07(0.065)。cofrogliptin(10mg 和 25mg)与利格列汀治疗相比,组间差异符合非劣效性预设边界。治疗期间,24 周治疗期间常见不良事件(≥5%患者)的发生率在各组之间相似。无严重低血糖事件。

结论

在二甲双胍控制不佳的中国 2 型糖尿病患者中,cofrogliptin(Q2W)的降糖效果不劣于利格列汀(每日),且在 52 周的治疗中保持相似的安全性特征。

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