在2型糖尿病患者中,每周一次的exenatide与按目标定位的insulin glargine相比 (DURATION-3):一个开放式随机试验
Michaela Diamant1, Luc Van Gaal, Stephen Stranks
1Diabetes Centre, VU University Medical Centre, Amsterdam, Netherlands. m.diamant@vumc.nl
Lancet (London, England)
|July 9, 2010
概括
在2型糖尿病患者中,每周一次的exenatide与胰岛素glargine相比,提供了优越的血糖控制. 这种方便的治疗选择还具有较低的副作用和体重增加风险.
科学领域:
- 内分泌学 在内分泌学.
- 代谢疾病 代谢疾病
- 药理学 药理学是指药理学的学科.
背景情况:
- 2型糖尿病 (T2DM) 需要方便的治疗方法,有效的血糖控制和没有体重增加.
- 目前的治疗方法在方便性,疗效性和副作用方面往往存在挑战.
- 新的治疗策略对于有效管理T2DM至关重要.
研究的目的:
- 为了评估每周一次的exenatide与胰岛素glargine在改善血糖控制方面的有效性.
- 为了测试exenatide与胰岛素glargine相比提供更优异的HbA1c降低的假设.
- 评估T2DM患者治疗相关的不良事件和体重变化.
主要方法:
- 一项为期26周的,开放的,随机的,平行组研究,比较T2DM患者的exenatide和insulin glargine.
- 参与者接受了每周一次的exenatide (2 mg) 或每天一次的胰岛素glargine,添加到现有的降糖方案中.
- 主要终点是血红蛋白A1c (HbA1c) 与基线的变化,使用修改的治疗意图方法进行分析.
主要成果:
- 在26周 (p=0.012) 时,每周一次的exenatide与胰岛素glargine (-1.3%) 相比,在统计学上显著地减少了HbA1c (-1.5%).
- 较少的患者因不良事件而停止服用exenatide (5%) 与胰岛素glargine (1%) 相比.
- 该研究观察到HbA1c的治疗差异为-0.16%,有利于exenatide.
结论:
- 每周服用一次的埃克西纳提德是T2DM管理的有价值的治疗选择,特别是对于那些担心低血糖,体重增加和方便的患者.
- 埃克萨纳提德为实现血糖指数目标提供了一种有效的替代方案,具有有利的安全性.
- 这些发现支持在临床实践中使用exenatide来改善T2DM结果.
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