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口服司美格鲁肽在中国2型糖尿病患者中的疗效和安全性:PIONEER 11和12随机对照试验中按基线特征进行的亚组分析。

Efficacy and safety of oral semaglutide in Chinese participants with type 2 diabetes: Subgroup analyses by baseline characteristics in the PIONEER 11 and 12 randomised controlled trials.

作者信息

Ji Linong, Yuan Guoyue, Liu Jun, Zhang Bingjie, Liu Wenyan, Shen Zewei

机构信息

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

Department of Endocrinology, The Affiliated Hospital of Jiangsu University, Zhenjiang, China.

出版信息

Diabetes Obes Metab. 2025 Aug 22. doi: 10.1111/dom.70031.

Abstract

AIMS

This post hoc analysis investigates the impact of baseline characteristics on the efficacy and safety of oral semaglutide in a Chinese population with type 2 diabetes.

MATERIALS AND METHODS

Chinese participants from the PIONEER 11 and 12 trials with type 2 diabetes aged ≥18 years were randomised to once-daily oral semaglutide 3, 7, or 14 mg, or placebo (PIONEER 11) or sitagliptin 100 mg (PIONEER 12). Changes from baseline in HbA and body weight at week 26 were analysed in subgroups according to the following baseline characteristics: age, HbA, body mass index, duration of diabetes, and presence of gastrointestinal disease. Adverse events (AEs) by baseline subgroups were also assessed.

RESULTS

In total, 390 (PIONEER 11) and 1084 (PIONEER 12) Chinese participants with type 2 diabetes were evaluated. Most baseline characteristics were similar across the two trials in the different subgroups. Overall, greater reductions in HbA and body weight were observed with oral semaglutide versus comparators across the subgroups. A significant difference was observed for change in HbA by baseline HbA subgroups (p <0.05), with greater reductions observed in the subgroups with higher baseline HbA. Most AEs were gastrointestinal-related and mild-to-moderate.

CONCLUSIONS/INTERPRETATION: Oral semaglutide reduces HbA and body weight across a range of baseline subgroups in a Chinese population with type 2 diabetes without any unexpected additional safety concerns. These results support the use of oral semaglutide in a broad population in clinical practice.

摘要

目的

本事后分析研究基线特征对中国2型糖尿病患者口服司美格鲁肽疗效和安全性的影响。

材料与方法

年龄≥18岁的2型糖尿病患者来自PIONEER 11和12试验,随机分为每日一次口服司美格鲁肽3、7或14毫克,或安慰剂(PIONEER 11)或西格列汀100毫克(PIONEER 12)。根据以下基线特征在亚组中分析第26周时糖化血红蛋白(HbA)和体重相对于基线的变化:年龄、HbA、体重指数、糖尿病病程和胃肠道疾病的存在情况。还评估了基线亚组的不良事件(AE)。

结果

总共评估了390名(PIONEER 11)和1084名(PIONEER 12)中国2型糖尿病患者。在不同亚组的两项试验中,大多数基线特征相似。总体而言,与对照药物相比,口服司美格鲁肽在各亚组中均观察到糖化血红蛋白和体重有更大幅度的降低。基线HbA亚组的糖化血红蛋白变化存在显著差异(p<0.05),基线HbA较高的亚组降低幅度更大。大多数不良事件与胃肠道相关,且为轻至中度。

结论/解读:口服司美格鲁肽可降低中国2型糖尿病患者一系列基线亚组中的糖化血红蛋白和体重,且无任何意外的额外安全问题。这些结果支持在临床实践中广泛人群使用口服司美格鲁肽。

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