利拉格卢提德每天服用一次,对象是每天两次服用埃克西纳提德治疗2型糖尿病:一项为期26周的随机,并行组,跨国,开放标签试验 (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
概括
利拉格卢提德显著改善了血糖控制,并促进了2型糖尿病患者的体重减轻,比exenatide更有效. 利拉格卢提德也更好地耐受,恶心和低血糖症更少.
科学领域:
- 内分泌学 在内分泌学.
- 药理学 药理学 是一个学科.
- 代谢疾病 代谢疾病
背景情况:
- 葡萄糖类-1 (GLP-1) 受体激动剂提供依赖葡萄糖的作用和减肥的好处,使其与其他抗高血糖药物区别开来.
- 人类GLP-1类似物利拉格卢提德和基于埃克森丁的激动剂埃克森提德是这一类的关键治疗选择.
研究的目的:
- 为了比较liraglutide与exenatide的疗效和安全性,在2型糖尿病的成年人中使用甲胺,硫氨酸urea或两者都无法控制.
- 为了评估两种GLP-1受体激动剂之间的血糖控制,体重变化和不良事件概况的差异.
主要方法:
- 这是一项为期26周的开放式跨国研究,涉及464名患有2型糖尿病的成年人.
- 参与者每天接受1.8毫克的利拉格卢提德一次或每天两次接受10毫克的埃克赛纳提德作为附加疗法.
- 主要结局是糖基化血红蛋白 (HbA1c) 的变化;采用治疗意图分析.
主要成果:
- 利拉格卢提德在HbA1c的降低显著更大,相比于exenatide (-1.12%对比 -0.79%,p<0.0001).
- 较高比例的患者获得了HbA1c<7%与利拉格卢提德 (54%vs43%,p=0.0015).
- 利拉格卢提德也导致了更大的禁食血葡萄糖的减少,并且与不那么持续的恶心和不那么频繁的轻微低血糖症有关.
结论:
- 在2型糖尿病管理中,每天服用一次的利拉格卢提德提供了优越的血糖控制和改善的耐受性,而不是每天两次服用埃克西纳提德.
- 利拉格卢提德是一种有价值的治疗选择,特别是对于体重减轻和降低低血糖症风险是重要的考虑因素的患者.
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