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在2型糖尿病中杜拉古和心血管结果 (REWIND):双盲,随机,安慰剂对照试验
Hertzel C Gerstein1, Helen M Colhoun2, Gilles R Dagenais3
1Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada.
Lancet (London, England)
|June 14, 2019
概括
在患有2型糖尿病和高心血管风险的成年人中,杜拉古显著降低了心血管事件. 这种类似葡萄糖的-1受体激动剂为治疗糖尿病和预防心脏病提供了新的选择.
科学领域:
- 心脏病学
- 内分泌学
- 药理学
背景情况:
- 葡萄糖类-1 (GLP-1) 受体激动剂在2型糖尿病中显示出心血管方面的益处.
- 之前的研究表明,在高危患者中,某些GLP-1RAs的心血管结果有所降低.
- 在广泛的2型糖尿病患者群体中评估了杜拉格卢提德对心血管事件的影响.
研究的目的:
- 评估杜拉格卢提德降低主要心血管不良事件 (MACE) 的疗效.
- 评估杜拉格卢提德对2型糖尿病患者心血管疾病的影响.
- 通过一系列的血糖控制来确定dulaglutide的安全性和有效性.
主要方法:
- 这是一项多中心,随机,双盲,安慰剂对照试验,涉及9901名2型糖尿病患者.
- 年龄≥50岁且已确诊心血管疾病或风险因素的参与者每周接受皮下杜拉格卢提德 (1.5 mg) 或安慰剂.
- 主要终点是非致命性心肌梗塞,非致命性中风或心血管死亡的组合,评估时间为5. 4年.
主要成果:
- 与安慰剂相比,dulaglutide使初级复合结果降低了12% (HR为0.88,p=0.026).
- 复合结局的发生率为杜拉格卢提德的12. 0%,而安慰剂的13. 4%.
- 胃肠道不良事件发生的频率高于安慰剂 (34. 1%).
结论:
- 在中年和老年糖尿病患者中,可考虑使用杜拉古来控制血糖.
- 这些发现支持在2型糖尿病和高心血管风险患者中使用杜拉格卢.
- 在这种患者群体中,杜拉古具有良好的心血管风险概况.
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