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替格列汀与格列美脲联合治疗对印度2型糖尿病患者hs-CRP及心肾参数的多效性影响:一项开放标签随机对照试验

Pleiotropic effect of teneligliptin versus glimepiride add-on therapy on hs-CRP and cardiorenal parameters in Indian type 2 diabetes patients: An open-labeled randomized controlled trial.

作者信息

Kanimozhi M, Bisht Manisha, Bandyopadhyay Arkapal, Naithani Manisha, Handu Shailendra

机构信息

MD Pharmacology Resident, All India Institute of Medical Sciences, Virbhadra Road, Rishikesh, Uttarakhand, India.

Additional Professor, Department of Pharmacology, All India Institute of Medical Sciences, Virbhadra Road, Rishikesh, Uttarakhand, India.

出版信息

Perspect Clin Res. 2025 Jan-Mar;16(1):14-22. doi: 10.4103/picr.picr_265_23. Epub 2024 Jul 10.

Abstract

OBJECTIVE

The objective of the study was to estimate the pleiotropic effect of teneligliptin on high-sensitivity C-reactive protein (hs-CRP) levels and some cardiorenal parameters in comparison to glimepiride, both as add-on therapy to metformin.

METHODOLOGY

This 12-week open-label, parallel-group, randomized controlled trial was conducted among Indian people with type 2 diabetes mellitus and on metformin monotherapy with poor glycemic control (glycated hemoglobin >7% or 53 mmol/mol). The endpoints were mean change in hs-CRP levels, systolic blood pressure (SBP), diastolic blood pressure (DBP), serum creatinine, blood urea, estimated glomerular filtration rate (eGFR), and change in cardiovascular (CV) risk categories from baseline to end of 12 weeks.

RESULTS

Seventy participants were randomized (1:1) to receive either teneligliptin 20 mg once daily ( = 35) or glimepiride 1 mg twice daily (BD) ( = 35) as an add-on to metformin 500 mg BD. The mean age of the participants was 50.65 and 50.7 years in arms 1 and 2, respectively. At 12-weeks end, teneligliptin add-on caused a statistically significant reduction in hs-CRP compared to glimepiride in both per-protocol (PP) and intention-to-treat (ITT) sets. No significant difference was observed for changes in SBP and DBP, creatinine, urea, eGFR levels, and CV risk category in both PP and ITT sets.

CONCLUSION

Teneligliptin add-on resulted in favorable effects on hs-CRP levels and comparable effects on cardiorenal parameters compared to glimepiride add-on therapy at 12-weeks end.This trial has been prospectively registered in CTRI (Clinical Trials Registry of India). Registration number: CTRI/2021/08/035342.

摘要

目的

本研究的目的是评估与格列美脲相比,替格列汀作为二甲双胍的附加疗法对高敏C反应蛋白(hs-CRP)水平及一些心肾参数的多效性作用。

方法

本为期12周的开放标签、平行组、随机对照试验在印度2型糖尿病患者中进行,这些患者接受二甲双胍单药治疗但血糖控制不佳(糖化血红蛋白>7%或53 mmol/mol)。终点指标为hs-CRP水平、收缩压(SBP)、舒张压(DBP)、血清肌酐、血尿素、估算肾小球滤过率(eGFR)从基线到12周结束时的平均变化,以及心血管(CV)风险类别从基线到12周结束时的变化。

结果

70名参与者被随机分为两组(1:1),分别接受每日一次20 mg替格列汀(n = 35)或每日两次1 mg格列美脲(BD)(n = 35)作为500 mg BD二甲双胍的附加治疗。两组参与者的平均年龄分别为50.65岁和50.7岁。在12周结束时,在符合方案(PP)集和意向性分析(ITT)集中,与格列美脲相比,附加替格列汀导致hs-CRP有统计学意义的降低。在PP集和ITT集中,SBP、DBP、肌酐、尿素、eGFR水平及CV风险类别的变化均未观察到显著差异。

结论

在12周结束时,与附加格列美脲治疗相比,附加替格列汀对hs-CRP水平有有利影响,对心肾参数有相似影响。本试验已在CTRI(印度临床试验注册中心)进行前瞻性注册。注册号:CTRI/2021/08/035342。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11f9/11759232/a47f4efdbe65/PCR-16-14-g001.jpg

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