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CFDA批准上市安达唐®(达格列净片)审评概述,用于2型糖尿病成年患者的血糖控制

2017-11-28 新浪医药 新浪医药

达格列净片(Dapagliflozin,商品名:安达唐/ FORXIGA)是一种高度选择性的钠-葡萄糖协同转运蛋白2(SGLT2)抑制剂,其作用机制不依赖于胰岛素,而是通过抑制SGLT2,减少滤过葡萄糖的重吸收,降低葡萄糖的肾阈值,从而增加尿糖排泄。本次在我国批准用于2型糖尿病成年患者的血糖控制,规格为5mg、10mg,推荐起始剂量为5 mg每日一次。对于需加强血糖控制且耐受5 mg每日一次的患者


达格列净片(Dapagliflozin,商品名:安达唐/ FORXIGA)是一种高度选择性的钠-葡萄糖协同转运蛋白2(SGLT2)抑制剂,其作用机制不依赖于胰岛素,而是通过抑制SGLT2,减少滤过葡萄糖的重吸收,降低葡萄糖的肾阈值,从而增加尿糖排泄。

本次在我国批准用于2型糖尿病成年患者的血糖控制,规格为5mg、10mg,推荐起始剂量为5 mg每日一次。对于需加强血糖控制且耐受5 mg每日一次的患者,剂量可增加至10 mg每日一次。

截至2011年7月15日,该品种在国外已完成了47个临床研究,超过8500名受试者参加了2b/3期临床研究。在国内完成了3项临床试验:2项共28名健康受试者参与的单次和多次给药的药代动力学研究,和1项随机、双盲、安慰剂对照的单药治疗国际多中心3期临床试验。3期试验共有326 例中国患者参与研究,以1:1:1的比例,随机分入3个治疗组,分别接受达格列净片5mg/天、达格列净片10mg/天或安慰剂治疗。研究结果表明:治疗第24周时,糖化血红蛋白(HbA1c)在达格列净5mg/天治疗组、10mg/天治疗组和安慰剂组相对于基线的下降值分别为1.06% 、1.16%和0.36%。平均空腹血糖的变化、餐后2小时血糖的变化、达到糖化血红蛋白水平<7.0%受试者比例、体重减轻等方面,本品各个剂量水平均优于安慰剂组。10mg剂量组在有效性数值上均优于5mg剂量组。总体上,我国患者的有效性数据与亚洲和全球数据基本一致。

该品种在患者的耐受性较好,在有中国患者参与的单药治疗的国际多中心试验中,治疗组与安慰剂对照组不良事件发生率相似,发生与药物相关的治疗后不良事件的受试者比例达格列净5mg、10mg和安慰剂组分别为15.1%、15.5%和16.4%。按照系统器官分类划分,属于感染与侵染性疾病分类的系统器官分类报告的不良事件最为常见(18.7%),各治疗组报告受试者人数比例相似。发生至少一起低血糖事件的受试者人数比例很低,仅达格列净5mg治疗组有1例受试者(占0.9%),安慰剂组有2例受试者(占1.8%)发生了一起低血糖事件,全部为轻到中度且无受试者因低血糖而中止研究。我国患者的安全性数据与全球和亚洲数据基本相似,未发现新的安全性问题。

该品种的心血管风险meta分析结果显示本品治疗与不可接受的心血管风险增加无关。MACE的HR估值为0.793 (95% CI: 0.537, 1.170),达到了心血管指南的要求和HR<1.3的 98% CI上限。随着暴露量和不良事件数量增加以及高心血管风险受试者的数量增加,预计风险比下降、95% CI变小。

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    2018-02-10 bugit
  2. [GetPortalCommentsPageByObjectIdResponse(id=1839551, encodeId=f5c61839551c6, content=<a href='/topic/show?id=341ae311ea' target=_blank style='color:#2F92EE;'>#FDA批准#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7311, encryptionId=341ae311ea, topicName=FDA批准)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=bugit, createdTime=Sat Feb 10 21:11:00 CST 2018, time=2018-02-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1890672, encodeId=54d018906e236, content=<a href='/topic/show?id=a867452008' target=_blank style='color:#2F92EE;'>#CFDA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4520, encryptionId=a867452008, topicName=CFDA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1a19115, createdName=stfoxst, createdTime=Wed Dec 27 19:11:00 CST 2017, time=2017-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1272974, encodeId=9f7712e297495, content=<a href='/topic/show?id=2f468983351' target=_blank style='color:#2F92EE;'>#血糖控制#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89833, encryptionId=2f468983351, topicName=血糖控制)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ef84111, createdName=whlxd, createdTime=Thu Nov 30 01:11:00 CST 2017, time=2017-11-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=265022, encodeId=06e526502212, content=不错不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=112, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/23/1c0aee311e523656afad7a58a5188a50.jpg, createdBy=291f2205699, createdName=15520c48c2m, createdTime=Tue Nov 28 10:33:15 CST 2017, time=2017-11-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=265021, encodeId=bd0926502166, content=了解了呀, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/23/1c0aee311e523656afad7a58a5188a50.jpg, createdBy=291f2205699, createdName=15520c48c2m, createdTime=Tue Nov 28 10:33:04 CST 2017, time=2017-11-28, status=1, ipAttribution=)]
    2017-12-27 stfoxst
  3. [GetPortalCommentsPageByObjectIdResponse(id=1839551, encodeId=f5c61839551c6, content=<a href='/topic/show?id=341ae311ea' target=_blank style='color:#2F92EE;'>#FDA批准#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7311, encryptionId=341ae311ea, topicName=FDA批准)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=bugit, createdTime=Sat Feb 10 21:11:00 CST 2018, time=2018-02-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1890672, encodeId=54d018906e236, content=<a href='/topic/show?id=a867452008' target=_blank style='color:#2F92EE;'>#CFDA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4520, encryptionId=a867452008, topicName=CFDA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1a19115, createdName=stfoxst, createdTime=Wed Dec 27 19:11:00 CST 2017, time=2017-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1272974, encodeId=9f7712e297495, content=<a href='/topic/show?id=2f468983351' target=_blank style='color:#2F92EE;'>#血糖控制#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89833, encryptionId=2f468983351, topicName=血糖控制)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ef84111, createdName=whlxd, createdTime=Thu Nov 30 01:11:00 CST 2017, time=2017-11-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=265022, encodeId=06e526502212, content=不错不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=112, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/23/1c0aee311e523656afad7a58a5188a50.jpg, createdBy=291f2205699, createdName=15520c48c2m, createdTime=Tue Nov 28 10:33:15 CST 2017, time=2017-11-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=265021, encodeId=bd0926502166, content=了解了呀, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/23/1c0aee311e523656afad7a58a5188a50.jpg, createdBy=291f2205699, createdName=15520c48c2m, createdTime=Tue Nov 28 10:33:04 CST 2017, time=2017-11-28, status=1, ipAttribution=)]
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    2017-11-28 15520c48c2m

    不错不错

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1839551, encodeId=f5c61839551c6, content=<a href='/topic/show?id=341ae311ea' target=_blank style='color:#2F92EE;'>#FDA批准#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7311, encryptionId=341ae311ea, topicName=FDA批准)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=bugit, createdTime=Sat Feb 10 21:11:00 CST 2018, time=2018-02-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1890672, encodeId=54d018906e236, content=<a href='/topic/show?id=a867452008' target=_blank style='color:#2F92EE;'>#CFDA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4520, encryptionId=a867452008, topicName=CFDA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1a19115, createdName=stfoxst, createdTime=Wed Dec 27 19:11:00 CST 2017, time=2017-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1272974, encodeId=9f7712e297495, content=<a href='/topic/show?id=2f468983351' target=_blank style='color:#2F92EE;'>#血糖控制#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89833, encryptionId=2f468983351, topicName=血糖控制)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ef84111, createdName=whlxd, createdTime=Thu Nov 30 01:11:00 CST 2017, time=2017-11-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=265022, encodeId=06e526502212, content=不错不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=112, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/23/1c0aee311e523656afad7a58a5188a50.jpg, createdBy=291f2205699, createdName=15520c48c2m, createdTime=Tue Nov 28 10:33:15 CST 2017, time=2017-11-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=265021, encodeId=bd0926502166, content=了解了呀, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/23/1c0aee311e523656afad7a58a5188a50.jpg, createdBy=291f2205699, createdName=15520c48c2m, createdTime=Tue Nov 28 10:33:04 CST 2017, time=2017-11-28, status=1, ipAttribution=)]
    2017-11-28 15520c48c2m

    了解了呀

    0

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