度拉糖肽针对广泛人群2型糖尿病患者心血管事件减少显示优效:REWIND研究中,基线时确诊心血管疾病患者仅有31%

2018-11-06 MedSci MedSci

度拉糖肽显著减少主要心血管不良事件(MACE),即包括心血管(CV)死亡、非致死性心肌梗死(心脏病发作)或非致死性卒中的复合终点,达到了REWIND研究预先设立的主要疗效目标。 礼来公司每周给药一次的度拉糖肽,是第一个在大部分为无确诊心血管疾病受试者的临床试验中被证实具有改善MACE事件获益的2型糖尿病治疗药物。 该研究纳入的大多数患者在基线时无确诊心血管疾病,这是第一个GLP-1受体激动剂

度拉糖肽显著减少主要血管不良事件(MACE),即包括血管(CV)死亡、非致死性心肌梗死(心脏病发作)或非致死性卒中的复合终点,达到了REWIND研究预先设立的主要疗效目标。 礼来公司每周给药一次的度拉糖肽,是第一个在大部分为无确诊心血管疾病受试者的临床试验中被证实具有改善MACE事件获益的2型糖尿病治疗药物。

该研究纳入的大多数患者在基线时无确诊心血管疾病,这是第一个GLP-1受体激动剂类药物的心血管结局研究如此设计。REWIND研究评估了患有各种心血管风险的成人2型糖尿病患者的MACE事件风险。该研究在标准治疗的基础上,比较了每周给药一次的度拉糖肽1.5mg与安慰剂的疗效。

“REWIND是一项雄心勃勃的研究,评估了度拉糖肽能否保护2型糖尿病患者免于出现首次心血管事件,以及预防既往患有心血管疾病患者出现进一步心血管事件”Hertzel Gerstein,医学博士,FRCPC,医学教授,麦克马斯特大学人类健康研究所和汉密尔顿健康科学研究所副主任,REWIND研究负责人说道“度拉糖肽在广泛的2型糖尿病人群中能减少MACE发生,令人震撼,我们期待分析及报告所有研究数据。”

REWIND研究与其他心血管结局研究相比的独特之处在于,已确诊心血管疾病的参与研究受试者数量有限,这可以让我们在广泛2型糖尿病人群中观察度拉糖肽的心血管效应。重要的是,REWIND研究的中位随访时间超过5年,这是在GLP-1受体激动剂类药物的心血管结局研究中观察时间最长的。相比之下,其他心血管结局研究纳入的患者基线A1C较高且确诊心血管疾病的患者比例极高。在REWIND研究的9,901例患者中,平均A1C基线相对较低为7.3%,仅31%患者有确诊的心血管疾病。

“REWIND研究中的这些广泛的2型糖尿病患者,包括有心血管疾病和无心血管疾病的患者,印证了此预先设定研究中这些发现的重要性,” 礼来美国及礼来糖尿病事业部总裁

康恩瑞(Enrique Conterno)表示“2型糖尿病患者普遍面临着心血管疾病的高风险。这些数据进一步证实了度拉糖肽是2型糖尿病治疗的明确之选。”

REWIND研究中度拉糖肽的安全性与GLP-1受体激动剂类药物相似。礼来公司计划明年将这些数据提交给监管机构,并在2019年的ADA科学会议上分享详细的研究结果。

度拉糖肽在中国已进入药审中心优先审评,目前还未获批上市。

关于REWIND研究

REWIND研究(研究糖尿病每周给药一次的肠促胰素治疗的心血管事件)是一项多中心、随机、双盲、安慰剂对照的研究,旨在评估度拉糖肽1.5mg,一种每周给药一次的GLP-1受体激动剂(GLP-1 RA),在标准治疗的基础上,与安慰剂相比较,改善成人2型糖尿病患者的心血管(CV)事件的疗效。主要心血管事件的观察终点是首次出现MACE事件(心血管死亡或非致死性心肌梗死或非致死性中风的复合事件)。次要终点包括主要复合心血管事件的每个组成部分,包括视网膜或肾脏疾病的复合临床微血管事件,不稳定性心绞痛的住院治疗,需要住院或急诊治疗心力衰竭,以及全因死亡率。9,901例患者来自24个国家,平均糖尿病病程为10年,平均A1C基线为7.3%。31%受试者在基线时确诊为心血管疾病。REWIND研究的既往(或诊断的)心血管疾病被定义为既往心肌梗死、既往缺血性卒中、既往不稳定性心绞痛、既往血运重建(冠状动脉,颈动脉或外周血管)、既往缺血相关事件住院治疗(不稳定型心绞痛或心肌缺血、影像学诊断或需要经皮冠状动脉介入治疗),或既往有记录的心肌缺血病史。

REWIND研究是一项全球性研究,女性受试者比例高,无确诊心血管疾病的患者比例高,受试者的平均基线A1C较低,表明该研究结果可以直接反应全球临床中常见的2型糖尿病患者的现状。

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    2018-11-08 xiaogang319
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  7. [GetPortalCommentsPageByObjectIdResponse(id=1643579, encodeId=590216435e968, content=<a href='/topic/show?id=6236895092b' target=_blank style='color:#2F92EE;'>#血管事件#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89509, encryptionId=6236895092b, topicName=血管事件)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f99523187183, createdName=hukaixun, createdTime=Mon Feb 25 03:44:00 CST 2019, time=2019-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1799063, encodeId=79a21e9906310, content=<a href='/topic/show?id=38e0e0670ff' target=_blank style='color:#2F92EE;'>#疾病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70670, encryptionId=38e0e0670ff, topicName=疾病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c859411, createdName=hmwwww, createdTime=Wed Nov 28 13:44:00 CST 2018, time=2018-11-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1322660, encodeId=399b1322660ff, content=<a href='/topic/show?id=d5764939166' target=_blank style='color:#2F92EE;'>#度拉糖肽#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=49391, encryptionId=d5764939166, topicName=度拉糖肽)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4736501, createdName=xiaoyang_ambs, createdTime=Thu Nov 08 11:44:00 CST 2018, time=2018-11-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1383500, encodeId=be881383500d8, content=<a href='/topic/show?id=196a1101f7' target=_blank style='color:#2F92EE;'>#2型糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1101, encryptionId=196a1101f7, topicName=2型糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec19483, createdName=aids213, createdTime=Thu Nov 08 11:44:00 CST 2018, time=2018-11-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1469123, encodeId=43001469123a3, content=<a href='/topic/show?id=211f98250b' target=_blank style='color:#2F92EE;'>#IND#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9825, encryptionId=211f98250b, topicName=IND)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=16377007930, createdName=xiaogang319, createdTime=Thu Nov 08 11:44:00 CST 2018, time=2018-11-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1474642, encodeId=a33914e46426c, content=<a href='/topic/show?id=935fe6718e3' target=_blank style='color:#2F92EE;'>#糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76718, encryptionId=935fe6718e3, topicName=糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a38f7243741, createdName=xue8604, createdTime=Thu Nov 08 11:44:00 CST 2018, time=2018-11-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1498494, encodeId=13d4149849417, content=<a href='/topic/show?id=bb6f89e145a' target=_blank style='color:#2F92EE;'>#血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89714, encryptionId=bb6f89e145a, topicName=血管疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ccb99370406, createdName=andy2090, createdTime=Thu Nov 08 11:44:00 CST 2018, time=2018-11-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=351848, encodeId=20f335184881, content=学习了,谢谢作者分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3xJXLtMtt5B40XXuPjn9xn1rBhrM6fHLkX1hI86ZoWoPJkgDkZuJNKkBfBHOcRd1fAdezg7JlHNOokohdAp3WkI/0, createdBy=32c81964262, createdName=1e145228m78(暂无匿称), createdTime=Wed Nov 07 16:47:11 CST 2018, time=2018-11-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1042018, encodeId=f8201042018b9, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Tue Nov 06 23:44:00 CST 2018, time=2018-11-06, status=1, ipAttribution=)]
  8. [GetPortalCommentsPageByObjectIdResponse(id=1643579, encodeId=590216435e968, content=<a href='/topic/show?id=6236895092b' target=_blank style='color:#2F92EE;'>#血管事件#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89509, encryptionId=6236895092b, topicName=血管事件)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f99523187183, createdName=hukaixun, createdTime=Mon Feb 25 03:44:00 CST 2019, time=2019-02-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1799063, encodeId=79a21e9906310, content=<a href='/topic/show?id=38e0e0670ff' target=_blank style='color:#2F92EE;'>#疾病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70670, encryptionId=38e0e0670ff, topicName=疾病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c859411, createdName=hmwwww, createdTime=Wed Nov 28 13:44:00 CST 2018, time=2018-11-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1322660, encodeId=399b1322660ff, content=<a href='/topic/show?id=d5764939166' target=_blank style='color:#2F92EE;'>#度拉糖肽#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=49391, encryptionId=d5764939166, topicName=度拉糖肽)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4736501, createdName=xiaoyang_ambs, createdTime=Thu Nov 08 11:44:00 CST 2018, time=2018-11-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1383500, encodeId=be881383500d8, content=<a href='/topic/show?id=196a1101f7' target=_blank style='color:#2F92EE;'>#2型糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1101, encryptionId=196a1101f7, topicName=2型糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec19483, createdName=aids213, createdTime=Thu Nov 08 11:44:00 CST 2018, time=2018-11-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1469123, encodeId=43001469123a3, content=<a href='/topic/show?id=211f98250b' target=_blank style='color:#2F92EE;'>#IND#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9825, encryptionId=211f98250b, topicName=IND)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=16377007930, createdName=xiaogang319, createdTime=Thu Nov 08 11:44:00 CST 2018, time=2018-11-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1474642, encodeId=a33914e46426c, content=<a href='/topic/show?id=935fe6718e3' target=_blank style='color:#2F92EE;'>#糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76718, encryptionId=935fe6718e3, topicName=糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a38f7243741, createdName=xue8604, createdTime=Thu Nov 08 11:44:00 CST 2018, time=2018-11-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1498494, encodeId=13d4149849417, content=<a href='/topic/show?id=bb6f89e145a' target=_blank style='color:#2F92EE;'>#血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89714, encryptionId=bb6f89e145a, topicName=血管疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ccb99370406, createdName=andy2090, createdTime=Thu Nov 08 11:44:00 CST 2018, time=2018-11-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=351848, encodeId=20f335184881, content=学习了,谢谢作者分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3xJXLtMtt5B40XXuPjn9xn1rBhrM6fHLkX1hI86ZoWoPJkgDkZuJNKkBfBHOcRd1fAdezg7JlHNOokohdAp3WkI/0, createdBy=32c81964262, createdName=1e145228m78(暂无匿称), createdTime=Wed Nov 07 16:47:11 CST 2018, time=2018-11-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1042018, encodeId=f8201042018b9, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Tue Nov 06 23:44:00 CST 2018, time=2018-11-06, status=1, ipAttribution=)]
    2018-11-07 1e145228m78(暂无匿称)

    学习了,谢谢作者分享!

    0

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    2018-11-06 misszhang

    谢谢MedSci提供最新的资讯

    0

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Lancet diabetes endo:度拉糖肽作为SGLT2抑制剂的补充治疗,用于血糖控制效果欠佳的2型糖尿病患者的效果和安全性

GLP-1受体兴奋剂和钠-葡萄糖共转运体-2(SGLT2)抑制剂可通过不同的机制改善2型糖尿病患者的血糖控制,并减轻其体重。近日,Lancet子刊上发表一篇文章,对采用SGLT2抑制剂治疗(联合或未联合二甲双胍)未能很好的控制血糖的2型糖尿病患者,每周补充一次GLP-1受体兴奋剂度拉糖肽(dulaglutide)的疗效和安全性进行评估。研究人员在多个国家的40个临床中心进行一双盲、平行臂、安慰剂为