每周一次的胰岛素Icodec与每天一次的长效胰岛素治疗II型糖尿病:随机对照试验的元分析
Mohamed Abuelazm1, Ahmed A Ibrahim2, Yehya Khlidj3
1Faculty of Medicine, Tanta University, Tanta 31111, Egypt.
Journal of the Endocrine Society
|January 12, 2024
概括
胰岛素icodec有效降低HbA1c,并增加了II型糖尿病患者的时间范围. 然而,与其他长效胰岛素相比,它也会导致体重增加和整体不良事件发生率增加.
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:
- 二型糖尿病 (T2DM) 的管理通常涉及基础胰岛素治疗.
- 新型胰岛素类似物旨在改善血糖控制和患者的便利性.
- 胰岛素icodec为基础胰岛素需求提供每周一次皮下注射.
研究的目的:
- 评估胰岛素icodec与已知长效胰岛素类似物 (胰岛素glargine和degludec) 相比的疗效和安全性.
- 综合随机对照试验 (RCT) 的证据,进行全面的评估.
主要方法:
- 进行了RCT的系统审查和元分析.
- 在PubMed,科学网,SCOPUS和Cochrane数据库中进行文献搜索,截至2023年5月29日.
- 数据使用Review Manager (RevMan) V. 5.4进行了聚合,分析了二分法数据与风险比率 (RR) 和连续数据与平均差异 (MD),两者均具有95%的置信区间 (CI).
主要成果:
- 包括7个涉及3183名患者的RCT.
- 胰岛素icodec显示了糖化血红蛋白 (HbA1c) 的显著降低 (MD: -0.15; 95% CI [-0.24, -0.06]) 和葡萄糖范围 (TIR) 的时间增加 (MD: 4.06; 95% CI [2.06, 6.06]).
- 使用胰岛素icodec观察到体重显著增加 (MD: 0.57; 95% CI [0.45, 0.70]) 和整体不良事件 (AEs) 发生率 (RR: 1.06; 95% CI [1.01, 1.12]),而严重的AEs和导致戒断的AEs没有显著差异.
结论:
- 胰岛素icodec在降低HbA1c和改善TIR方面提供了与其他长效胰岛素相似的疗效.
- 每周一次的基础胰岛素类似物与体重增加和任何不良事件的发生率更高有关.
- 低血糖事件和严重不良事件在胰岛素icodec和比较胰岛素之间是相似的.
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