Lancet Diabetes Endocrinol:GLP类似物Semaglutide比甘精胰岛素疗法更具优势

2017-03-24 MedSci MedSci原创

GLP类似物Semaglutide对二甲双胍效果不佳的II型糖尿病患者比甘精胰岛素疗法更具优势

诺和诺德公司近日宣布,GLP类似物Semaglutide对二甲双胍效果不佳的II型糖尿病患者比甘精胰岛素疗法更具优势,该研究结果发表于Lancet Dibetes Endo。

在一项名为SUSTAIN 4的IIIa期临床试验中,1089名18岁以上的,单独使用二甲双胍或与磺脲类药物联合血糖控制效果不佳的、且未经过胰岛素治疗的II型糖尿病患者参与了临床研究。其中362名受试者接受0.5 mg的Semaglutide(每周注射一次),360名受试者接受1.0mg的Semaglutide(每周注射一次),360名受试者接受每天一次的甘精胰岛素(起始剂量为10 IU),试验治疗一共持续30周。

试验的主要终点是从开始到30周平均糖化血红蛋白变化,次要终点是从开始到30周的平均体重变化。

结果显示,对于平均糖化血红蛋白,30周后,0.5mg Semaglutide组减少1.21%(95% Cl 1.10至1.31), 1.0mg Semaglutide组减少1.64%(95% Cl 1.54至1.74),而甘精胰岛素组平均糖化血红蛋白仅减少0.83%(95% Cl 0.73-0.93);平均体重起始基线为93.45 kg (SD 21.79),治疗30周后,0.5mg Semaglutide组与1.0mg Semaglutide组体重分别减少3.47 kg(95% CI 3.00-3.93)和5.17 kg(95% CI 4.71-5.66),而甘精胰岛素组体重增加1.15 kg。2个剂量的Semaglutide 组严重低血糖发生率均低于甘精胰岛素组,试验中有6名病人死亡(Semaglutide组4人,甘精胰岛素组2人;5人死因为心血管疾病,Semaglutide组1人死于胰腺癌),Semaglutide组最常见的不良事件为恶心(21% vs 22%,0.5mg vs 1mg),甘精胰岛素组为鼻咽炎(12%)。

研究者认为,相比甘精胰岛素,Semaglutide可以更好的控制糖化血红蛋白和体重,减少低血糖的风险,耐受性好,安全性与其他类似的GLP-1受体激动剂的相当。

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    2018-01-07 baoya
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    2017-09-25 howi
  4. 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createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Sat Mar 25 09:16:42 CST 2017, time=2017-03-25, status=1, ipAttribution=)]
  5. 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createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Sat Mar 25 09:16:42 CST 2017, time=2017-03-25, status=1, ipAttribution=)]
  6. 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objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=16126, encryptionId=db1c1612602, topicName=semaglutide)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=214a22029963, createdName=lfyang, createdTime=Mon Dec 04 00:51:00 CST 2017, time=2017-12-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1317262, encodeId=f06f131e26289, content=<a href='/topic/show?id=74916e0414' target=_blank style='color:#2F92EE;'>#EMA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6704, encryptionId=74916e0414, topicName=EMA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a35a460, createdName=fengyi812, createdTime=Sat Mar 25 23:51:00 CST 2017, time=2017-03-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1393166, encodeId=1e1f139316668, content=<a href='/topic/show?id=eb2b6882506' target=_blank style='color:#2F92EE;'>#甘精胰岛素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=68825, encryptionId=eb2b6882506, topicName=甘精胰岛素)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIUEDhSibBFt8TicgFCCSBtW10SxVJicDpibTCucns8L1YaiaKpibWOkv8hYpJ0LeTVUH1Ab4sfica9bxiccA/132, createdBy=dd282500126, createdName=ms3830150583600765, createdTime=Sat Mar 25 23:51:00 CST 2017, time=2017-03-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=182607, encodeId=a01218260ef8, content=相比甘精胰岛素,Semaglutide可以更好的控制糖化血红蛋白和体重,减少低血糖的风险,耐受性好,安全性与其他类似的GLP-1受体激动剂的相当。, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Sat Mar 25 09:16:42 CST 2017, time=2017-03-25, status=1, ipAttribution=)]
  7. 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objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=16126, encryptionId=db1c1612602, topicName=semaglutide)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=214a22029963, createdName=lfyang, createdTime=Mon Dec 04 00:51:00 CST 2017, time=2017-12-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1317262, encodeId=f06f131e26289, content=<a href='/topic/show?id=74916e0414' target=_blank style='color:#2F92EE;'>#EMA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6704, encryptionId=74916e0414, topicName=EMA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a35a460, createdName=fengyi812, createdTime=Sat Mar 25 23:51:00 CST 2017, time=2017-03-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1393166, encodeId=1e1f139316668, content=<a href='/topic/show?id=eb2b6882506' target=_blank style='color:#2F92EE;'>#甘精胰岛素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=68825, encryptionId=eb2b6882506, topicName=甘精胰岛素)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIUEDhSibBFt8TicgFCCSBtW10SxVJicDpibTCucns8L1YaiaKpibWOkv8hYpJ0LeTVUH1Ab4sfica9bxiccA/132, createdBy=dd282500126, createdName=ms3830150583600765, createdTime=Sat Mar 25 23:51:00 CST 2017, time=2017-03-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=182607, encodeId=a01218260ef8, content=相比甘精胰岛素,Semaglutide可以更好的控制糖化血红蛋白和体重,减少低血糖的风险,耐受性好,安全性与其他类似的GLP-1受体激动剂的相当。, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Sat Mar 25 09:16:42 CST 2017, time=2017-03-25, status=1, ipAttribution=)]
    2017-03-25 fengyi812
  8. 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encodeId=1e1f139316668, content=<a href='/topic/show?id=eb2b6882506' target=_blank style='color:#2F92EE;'>#甘精胰岛素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=68825, encryptionId=eb2b6882506, topicName=甘精胰岛素)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIUEDhSibBFt8TicgFCCSBtW10SxVJicDpibTCucns8L1YaiaKpibWOkv8hYpJ0LeTVUH1Ab4sfica9bxiccA/132, createdBy=dd282500126, createdName=ms3830150583600765, createdTime=Sat Mar 25 23:51:00 CST 2017, time=2017-03-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=182607, encodeId=a01218260ef8, content=相比甘精胰岛素,Semaglutide可以更好的控制糖化血红蛋白和体重,减少低血糖的风险,耐受性好,安全性与其他类似的GLP-1受体激动剂的相当。, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Sat Mar 25 09:16:42 CST 2017, time=2017-03-25, status=1, ipAttribution=)]
    2017-03-25 ylzr123

    相比甘精胰岛素,Semaglutide可以更好的控制糖化血红蛋白和体重,减少低血糖的风险,耐受性好,安全性与其他类似的GLP-1受体激动剂的相当。

    0

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