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DRCP:亚洲2型糖尿病患者利拉鲁肽的药代动力学和剂量暴露反应的联系

2015-03-04 范伟译 MedSci原创

目的:在亚洲2型糖尿病患者中,调查群体药代动力学和利拉鲁肽暴露反应的关系,利拉鲁肽——人胰高血糖素样肽-1(GLP-1)类似物。 方法:数据来源于中国,印度和韩国第16周发表的随机,双盲,双模拟,主动控制的利拉鲁肽的平行对照试验。分析利用605个每天一次暴露于利拉鲁肽0.6mg,1.2或1.8mg的患者的2061个药代动力学(PK)样品。利拉鲁肽清除率的人口因素(年龄,体重,性别,国家)的重要性

目的:在亚洲2糖尿病患者中,调查群体药代动力学和利拉鲁肽暴露反应的关系,利拉鲁肽——人胰高血糖素样肽-1GLP-1)类似物。

方法:数据来源于中国,印度和韩国第16周发表的随机,双盲,双模拟,主动控制的利拉鲁肽的平行对照试验。分析利用605个每天一次暴露于利拉鲁肽0.6mg1.21.8mg的患者的2061个药代动力学(PK)样品。利拉鲁肽清除率的人口因素(年龄,体重,性别,国家)的重要性需进行评价。探索性的暴露-反应分析研究了糖化血红蛋白(HbA1c)和体重的影响。

结果:预估利拉鲁肽的暴露(曲线下面积;AUC)随利拉鲁肽剂量的增加(0.6-1.8mg)也出现成比例的增加。在全球临床试验中协方差分析证实了先前的研究结果。体重是利拉鲁肽暴露的预测因素;相对于67kg参考体重,最高体重(115公斤)暴露有32%的降低,最低体重(37公斤)暴露有54%的增加。性别,年龄,国家对暴露没有相关的效果。暴露-反应分析支持1.2mg的使用作为维持剂量,个人剂量升级到1.8mg能优化治疗效果。

结论:随着亚洲2糖尿病患者利拉鲁肽剂量的增加暴露也呈现成比例的增加。暴露唯一相关的药代动力学预测因子是体重。在亚洲患者中糖化血红蛋白和体重的暴露-反应关系与观察到的全球人口类似。

原始出处

Ingwersen SH, Petri KC, Tandon N, Yoon KH, Chen L, Vora J, Yang W. Liraglutide pharmacokinetics and dose-exposure response in Asian subjects with Type 2 diabetes from China, India and South Korea. Diabetes Res Clin Pract. 2015 Jan 19. pii: S0168-8227(15)00007-8. doi: 10.1016/j.diabres.2015.01.001.

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    2015-07-17 fengyqf
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    2015-08-08 shuaijing1986

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1666631, encodeId=bc8916666319a, content=<a href='/topic/show?id=df6a8e287d7' target=_blank style='color:#2F92EE;'>#药代#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87287, encryptionId=df6a8e287d7, topicName=药代)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=bccf26064950, createdName=fengyqf, createdTime=Fri Jul 17 13:54:00 CST 2015, time=2015-07-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=35270, encodeId=5fe6352e00a, content=啊, beContent=null, objectType=article, channel=null, level=null, likeNumber=124, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=78351636049, createdName=shuaijing1986, createdTime=Sat Aug 08 05:10:00 CST 2015, time=2015-08-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=35269, encodeId=9d0f3526914, content=啊, beContent=null, objectType=article, channel=null, level=null, likeNumber=130, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=78351636049, createdName=shuaijing1986, createdTime=Sat Aug 08 05:10:00 CST 2015, time=2015-08-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=35268, encodeId=1d65352682a, content=去, beContent=null, objectType=article, channel=null, level=null, likeNumber=135, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=78351636049, createdName=shuaijing1986, createdTime=Sat Aug 08 05:10:00 CST 2015, time=2015-08-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=27140, encodeId=25b52e14085, content=好好学习一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=185, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=ac181616815, createdName=ljjj1053, createdTime=Thu Jun 11 18:52:00 CST 2015, time=2015-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=20358, encodeId=8c00203584b, content=AKI对心衰临床治疗意义重大,但依然需要研究检验其适用性, beContent=null, objectType=article, channel=null, level=null, likeNumber=142, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20150920/IMG55FDE671A89482379.jpg, createdBy=cef3108336, createdName=x35042875, createdTime=Sat Apr 11 22:42:00 CST 2015, time=2015-04-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1473857, encodeId=9a1814e3857f1, 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=56, 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=Fri Mar 06 00:54:00 CST 2015, time=2015-03-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1383169, encodeId=666313831697d, 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=68, 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=Fri Mar 06 00:54:00 CST 2015, time=2015-03-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1351253, encodeId=5d05135125317, content=<a href='/topic/show?id=9ac28e2893e' target=_blank style='color:#2F92EE;'>#药代动力学#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87289, encryptionId=9ac28e2893e, topicName=药代动力学)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Fri Mar 06 00:54:00 CST 2015, time=2015-03-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=17709, encodeId=513b1e7090a, content=好文章,攒, beContent=null, objectType=article, channel=null, level=null, likeNumber=122, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=36a81612921, createdName=xiaoai5777, createdTime=Thu Mar 05 15:12:00 CST 2015, time=2015-03-05, status=1, ipAttribution=)]
    2015-08-08 shuaijing1986

    0

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    2015-08-08 shuaijing1986

    0

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    2015-06-11 ljjj1053

    好好学习一下

    0

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    2015-04-11 x35042875

    AKI对心衰临床治疗意义重大,但依然需要研究检验其适用性

    0

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    2015-03-05 xiaoai5777

    好文章,攒

    0

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流行病学研究表明,肥胖、高热量饮食、体力活动不足及增龄是2型糖尿病最主要的环境因素,高血压、血脂异常等因素也会增加患病风险。但是目前,2型糖尿病与大多数心血管疾病的发病之间的关系尚未得到明确的报道。因此,来自英国伦敦大学的Shah教授带领了研究组进行了一项包含了一百九十万人群的队列研究,试图寻找2型糖尿病与12种心血管疾病的初始表现间的关联。该研究结果发表于The Lancet Diabete

点评:继续寻找2型糖尿病的基因是否有价值?

2型糖尿病是一种高度异质性的疾病,在复杂的基因背景下,营养物质过多摄入导致体内糖脂代谢异常,引起疾病发生。因此,遗传和环境是2型糖尿病发生的两大重要方面。正方Mark McCarthy和反方Mike Lean正是从这两个方面来看待目前关于2型糖尿病的研究。在遗传学方面,正如Mark McCarthy所说,通过GWAS研究和一些表观遗传学的研究从基础研究的角度在一定程度上揭示了基因在2型糖尿病发生中

Ann Surg:非重度肥胖的2型糖尿病患者,手术治疗VS内科治疗,孰优孰劣?

肥胖手术可以实现2型糖尿病和糖尿病并发症的缓解,手术治疗一直以来也被提倡用于糖尿病合并BMI小于35kg/m的患者人群,可作为备用治疗选择。然而减重手术的有限性还没背全面系统地证实。为比较外科手术治疗和内科治疗对于BMI指数少于35kg/m的2型糖尿病患者的缓解情况和并发症发生情况,XXX的研究者进行了一项Meta分析。系统检索文献内容为评估BMI<35kg/m的糖尿病患者外科和内科治疗的随

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