在2型糖尿病患者中,每周使用一次的exenatide和每天使用一次的liraglutide (持续时间-6):一种随机的开放性研究
John B Buse1, Michael Nauck, Thomas Forst
1University of North Carolina School of Medicine, Chapel Hill, NC, USA.
Lancet (London, England)
|November 13, 2012
概括
每天服用利拉格卢提德和每周服用埃克赛纳提德都改善了2型糖尿病的控制. 利拉格卢提德显示出更大的HbA1c降低,但有更多的恶心和吐副作用.
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:
- 类似葡萄糖类-1受体激动剂 (GLP-1 RAs),如埃克西纳提德和利拉格卢提德,已成为2型糖尿病的治疗方法,改善血糖控制并促进体重减轻.
- 这项研究直接比较了2型糖尿病患者每周服用一次埃塞纳提德的疗效和安全性与每天服用一次利拉格卢提德.
研究的目的:
- 在2型糖尿病患者中,比较每周一次的exenatide和每天一次的liraglutide的疗效和安全性.
- 为了评估26周治疗期间的糖化血红蛋白 (HbA1c) 变化作为主要终点.
主要方法:
- 这是一项开放的,随机的,并行组研究,涉及19个国家的912名2型糖尿病患者.
- 参与者每天接受1.8毫克的利拉格卢提德一次或每周一次接受2毫克的异化物,同时服用口服抗高血糖药物.
- 主要疗效终点是从基线到第26周的HbA1c变化,使用治疗意图方法进行分析.
主要成果:
- 利拉格卢提德在HbA1c (-1.48%) 的降低较大,相比于埃克萨纳提德 (-1.28%),尽管差异没有满足预定义的非劣质标准.
- 不良事件,特别是恶心,腹和吐,与liraglutide比exenatide更频繁.
- 由于不良事件而停止治疗的比例在利拉格卢提德组 (5%) 比异胺组 (3%) 高.
结论:
- 利拉格卢提德和埃克萨纳提德都有效地改善了2型糖尿病患者的血糖控制.
- 利拉古类药物实现了更大的HbA1c降低,但埃克西纳提德与更好的胃肠道耐受性和更少的剂量相关.
- 这些发现为临床医生在根据患者特定需求选择GLP-1RA时提供了宝贵的见解,这些见解涉及疗效,注射频率和耐受性.
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