Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, China.
Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, China.
Diabetes Obes Metab. 2024 Nov;26(11):5013-5024. doi: 10.1111/dom.15915. Epub 2024 Sep 23.
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.
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.
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.
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.
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。
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%。
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。
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。