2型糖尿病に対するリラグルチド1日1回対エクセナチド1日2回:26週間のランダム化,並列グループ,多国籍,オープンラベル試験 (LEAD-6)
John B Buse1, Julio Rosenstock, Giorgio Sesti
1Division of Endocrinology, University of North Carolina School of Medicine, Chapel Hill, NC, USA. jbuse@med.unc.edu
Lancet (London, England)
|June 12, 2009
まとめ
リラグルチドは,エキセナチドよりも2型糖尿病患者の血糖コントロールを大幅に改善し,体重減少を促進しました. また,リラグルチドは好調に耐えており,吐き気や低血糖症が少なくなりました.
科学分野:
- エンドクリノロジー エンドクリノロジー
- 薬理学 薬理学とは
- メタボリック疾患
背景:
- グルカゴン類ペプチド-1 (GLP-1) 受容体アゴニストは,グルコースに依存した作用と体重減少の利点を提供し,他の抗高血糖薬と区別します.
- ヒトのGLP-1アナログであるリラグルチドと,エクセンジンベースのアゴニストであるエクセナチドは,このクラスにおける重要な治療選択肢を表しています.
研究 の 目的:
- 2型糖尿病の成人におけるリラグルチドとエクセナチドの有効性と安全性を比較するには,メトホルミン,スルフォニル尿素,またはその両方によって不十分に制御されている.
- 2つのGLP-1受容体アゴニスト間の血糖制御,体重変化,および有害事象プロフィールの違いを評価する.
主な方法:
- 2型糖尿病の成人の464人を対象とした26週間のオープンラベル多国籍研究.
- 参加者は,リラグルチド1.8mgを1日1回,エクセナチド10mcgを1日2回,追加療法として投与された.
- 主なアウトカムは,グリコシル化ヘモグロビン (HbA1c) の変化であり,治療意図分析が採用されました.
主要な成果:
- リラグルチドは,エクセナチドと比較してHbA1cを著しく減少させた (-1.12% vs -0.79%,p<0.0001).
- リラグルチドでHbA1c <7%を達成した患者の割合はより高い (54%対43%,p=0.0015).
- リラグルチドはまた,断食時の血糖値のより大きな低下につながり,持続性の低い吐き気やより頻度の低い軽度の低血糖症と関連していました.
結論:
- 1日1回投与されたリラグルチドは,2型糖尿病の管理において,日2回投与されたエクセナチドと比較して,優れた血糖コントロールと改善された耐受性を提供します.
- リラグルチドは,特に体重減少と低血糖症のリスクを減らすことが重要な考慮事項である患者にとって,貴重な治療オプションです.
関連する概念動画
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