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Diabetes Care:利拉鲁肽治疗1型糖尿病的疗效和安全性研究(ADJUNCT TWO)

2016-09-19 Seven L 译 MedSci原创

目的:研究对象为1型糖尿病患者;在限制胰岛素剂量的基础上,添加利拉鲁肽,对这类患者的疗效和安全性如何? 方法:本项为期26周的安慰剂对照、双盲、平行试验,纳入了835名1型糖尿病患者,按3:1随机分为每日一次皮下注射利拉鲁肽(1.8,1.2,0.6 mg)或安慰剂组;所有患者每日总胰岛素剂量是有限制的。 结果:第26周时,利拉鲁肽组与安慰剂组相比,平均基线糖化血红蛋白(HbA1c)降低

目的:研究对象为1型糖尿病患者;在限制胰岛素剂量的基础上,添加利拉鲁肽,对这类患者的疗效和安全性如何?

方法:本项为期26周的安慰剂对照、双盲、平行试验,纳入了835名1型糖尿病患者,按3:1随机分为每日一次皮下注射利拉鲁肽(1.8,1.2,0.6 mg)或安慰剂组;所有患者每日总胰岛素剂量是有限制的。

结果:第26周时,利拉鲁肽组与安慰剂组相比,平均基线糖化血红蛋白(HbA1c)降低更多(1.8 mg: –0.33% [3.6 mmol/mol]; 1.2 mg: –0.22% [2.4 mmol/mol]; 0.6 mg: –0.23% [2.5 mmol/mol]; 安慰剂: 0.01% [0.1 mmol/mol])。

此外,利拉鲁肽组与安慰剂组相比,患者的体重明显下降(1.8 mg, 1.2 mg,0.6 mg和安慰剂组的体重弄下降分别为–5.1 kg, –4.0 kg,–2.5 kg和–0.2 kg)。

不仅如此,利拉鲁肽组与安慰剂组相比,每日使用的胰岛素剂量显著下降,生活质量显著上升。

利拉鲁肽1.2 mg组与安慰剂组相比,症状性低血糖发生率更高(21.3 vs. 16.6事件/人/年; P = 0.03);利拉鲁肽1.8 mg组与安慰剂组相比,伴酮症(>1.5 mmol/L)的高血糖发生率更高(0.5 vs. 0.1事件/人/年;P = 0.01)。

结论:对于1型糖尿病患者,在限制胰岛素治疗剂量的基础上,添加利拉鲁肽,可以显著降低患者的HbA1c、体重和胰岛素需求;但是当利拉鲁肽使用剂量为1.2 mg时,患者的症状性低血糖发生率更高;当剂量为1.8 mg时,患者伴酮症的高血糖发生率更高。

原始出处:

Bo Ahrén, Irl B. Hirsch,et al.Efficacy and Safety of Liraglutide Added to Capped Insulin Treatment in Subjects With Type 1 Diabetes: the ADJUNCT TWO Randomized Trial.Diabetes Care 2016 Aug

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  5. [GetPortalCommentsPageByObjectIdResponse(id=1759762, encodeId=b0621e597624e, content=<a href='/topic/show?id=9bea33520d' target=_blank style='color:#2F92EE;'>#BET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3352, encryptionId=9bea33520d, topicName=BET)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9a1a37427546, createdName=ms5439512287675881, createdTime=Sun Oct 23 08:03:00 CST 2016, time=2016-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1720803, encodeId=c2b81e20803e8, content=<a href='/topic/show?id=634ee040179' target=_blank style='color:#2F92EE;'>#疗效和安全性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70401, encryptionId=634ee040179, topicName=疗效和安全性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=16ef32982072, createdName=经常头晕, createdTime=Mon May 01 13:03:00 CST 2017, time=2017-05-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1901455, encodeId=8d93190145533, content=<a href='/topic/show?id=c097591ed5' target=_blank style='color:#2F92EE;'>#Diabetes#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5917, encryptionId=c097591ed5, topicName=Diabetes)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0045169, createdName=木头人513, createdTime=Sat Nov 26 12:03:00 CST 2016, time=2016-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1798759, encodeId=59ac1e9875946, content=<a href='/topic/show?id=3b62e0402fd' target=_blank style='color:#2F92EE;'>#疗效和安全性研究#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70402, encryptionId=3b62e0402fd, topicName=疗效和安全性研究)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=56ea361, createdName=changhe713, createdTime=Sat May 20 13:03:00 CST 2017, time=2017-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1637473, encodeId=ea18163e473e3, content=<a href='/topic/show?id=afda591646' target=_blank style='color:#2F92EE;'>#DIA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5916, encryptionId=afda591646, topicName=DIA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=987022654425, createdName=ms9608593228839890, createdTime=Fri Jul 28 23:03:00 CST 2017, time=2017-07-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=146582, encodeId=4f4714658222, content=分享一下!, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160817/IMG57B3C3F6DC2FD8753.jpg, createdBy=81321934679, createdName=1e0d99ddm02(暂无匿称), createdTime=Wed Oct 12 11:14:07 CST 2016, time=2016-10-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=146581, encodeId=271414658108, content=分享一下!, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160817/IMG57B3C3F6DC2FD8753.jpg, createdBy=81321934679, createdName=1e0d99ddm02(暂无匿称), createdTime=Wed Oct 12 11:14:00 CST 2016, time=2016-10-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=146580, encodeId=df56146580ee, content=总结的很好!, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160817/IMG57B3C3F6DC2FD8753.jpg, createdBy=81321934679, createdName=1e0d99ddm02(暂无匿称), createdTime=Wed Oct 12 11:13:55 CST 2016, time=2016-10-12, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1759762, encodeId=b0621e597624e, content=<a href='/topic/show?id=9bea33520d' target=_blank style='color:#2F92EE;'>#BET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3352, encryptionId=9bea33520d, topicName=BET)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9a1a37427546, createdName=ms5439512287675881, createdTime=Sun Oct 23 08:03:00 CST 2016, time=2016-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1720803, encodeId=c2b81e20803e8, content=<a href='/topic/show?id=634ee040179' target=_blank style='color:#2F92EE;'>#疗效和安全性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70401, encryptionId=634ee040179, topicName=疗效和安全性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=16ef32982072, createdName=经常头晕, createdTime=Mon May 01 13:03:00 CST 2017, time=2017-05-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1901455, encodeId=8d93190145533, content=<a href='/topic/show?id=c097591ed5' target=_blank style='color:#2F92EE;'>#Diabetes#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5917, encryptionId=c097591ed5, topicName=Diabetes)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0045169, createdName=木头人513, createdTime=Sat Nov 26 12:03:00 CST 2016, time=2016-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1798759, encodeId=59ac1e9875946, content=<a href='/topic/show?id=3b62e0402fd' target=_blank style='color:#2F92EE;'>#疗效和安全性研究#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70402, encryptionId=3b62e0402fd, topicName=疗效和安全性研究)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=56ea361, createdName=changhe713, createdTime=Sat May 20 13:03:00 CST 2017, time=2017-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1637473, encodeId=ea18163e473e3, content=<a href='/topic/show?id=afda591646' target=_blank style='color:#2F92EE;'>#DIA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5916, encryptionId=afda591646, topicName=DIA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=987022654425, createdName=ms9608593228839890, createdTime=Fri Jul 28 23:03:00 CST 2017, time=2017-07-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=146582, encodeId=4f4714658222, content=分享一下!, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160817/IMG57B3C3F6DC2FD8753.jpg, createdBy=81321934679, createdName=1e0d99ddm02(暂无匿称), createdTime=Wed Oct 12 11:14:07 CST 2016, time=2016-10-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=146581, encodeId=271414658108, content=分享一下!, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160817/IMG57B3C3F6DC2FD8753.jpg, createdBy=81321934679, createdName=1e0d99ddm02(暂无匿称), createdTime=Wed Oct 12 11:14:00 CST 2016, time=2016-10-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=146580, encodeId=df56146580ee, content=总结的很好!, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160817/IMG57B3C3F6DC2FD8753.jpg, createdBy=81321934679, createdName=1e0d99ddm02(暂无匿称), createdTime=Wed Oct 12 11:13:55 CST 2016, time=2016-10-12, status=1, ipAttribution=)]
    2016-10-12 1e0d99ddm02(暂无匿称)

    分享一下!

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  7. [GetPortalCommentsPageByObjectIdResponse(id=1759762, encodeId=b0621e597624e, content=<a href='/topic/show?id=9bea33520d' target=_blank style='color:#2F92EE;'>#BET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3352, encryptionId=9bea33520d, topicName=BET)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9a1a37427546, createdName=ms5439512287675881, createdTime=Sun Oct 23 08:03:00 CST 2016, time=2016-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1720803, encodeId=c2b81e20803e8, content=<a href='/topic/show?id=634ee040179' target=_blank style='color:#2F92EE;'>#疗效和安全性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70401, encryptionId=634ee040179, topicName=疗效和安全性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=16ef32982072, createdName=经常头晕, createdTime=Mon May 01 13:03:00 CST 2017, time=2017-05-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1901455, encodeId=8d93190145533, content=<a href='/topic/show?id=c097591ed5' target=_blank style='color:#2F92EE;'>#Diabetes#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5917, encryptionId=c097591ed5, topicName=Diabetes)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0045169, createdName=木头人513, createdTime=Sat Nov 26 12:03:00 CST 2016, time=2016-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1798759, encodeId=59ac1e9875946, content=<a href='/topic/show?id=3b62e0402fd' target=_blank style='color:#2F92EE;'>#疗效和安全性研究#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70402, encryptionId=3b62e0402fd, topicName=疗效和安全性研究)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=56ea361, createdName=changhe713, createdTime=Sat May 20 13:03:00 CST 2017, time=2017-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1637473, encodeId=ea18163e473e3, content=<a href='/topic/show?id=afda591646' target=_blank style='color:#2F92EE;'>#DIA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5916, encryptionId=afda591646, topicName=DIA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=987022654425, createdName=ms9608593228839890, createdTime=Fri Jul 28 23:03:00 CST 2017, time=2017-07-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=146582, encodeId=4f4714658222, content=分享一下!, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160817/IMG57B3C3F6DC2FD8753.jpg, createdBy=81321934679, createdName=1e0d99ddm02(暂无匿称), createdTime=Wed Oct 12 11:14:07 CST 2016, time=2016-10-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=146581, encodeId=271414658108, content=分享一下!, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160817/IMG57B3C3F6DC2FD8753.jpg, createdBy=81321934679, createdName=1e0d99ddm02(暂无匿称), createdTime=Wed Oct 12 11:14:00 CST 2016, time=2016-10-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=146580, encodeId=df56146580ee, content=总结的很好!, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160817/IMG57B3C3F6DC2FD8753.jpg, createdBy=81321934679, createdName=1e0d99ddm02(暂无匿称), createdTime=Wed Oct 12 11:13:55 CST 2016, time=2016-10-12, status=1, ipAttribution=)]
    2016-10-12 1e0d99ddm02(暂无匿称)

    分享一下!

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1759762, encodeId=b0621e597624e, content=<a href='/topic/show?id=9bea33520d' target=_blank style='color:#2F92EE;'>#BET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3352, encryptionId=9bea33520d, topicName=BET)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9a1a37427546, createdName=ms5439512287675881, createdTime=Sun Oct 23 08:03:00 CST 2016, time=2016-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1720803, encodeId=c2b81e20803e8, content=<a href='/topic/show?id=634ee040179' target=_blank style='color:#2F92EE;'>#疗效和安全性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70401, encryptionId=634ee040179, topicName=疗效和安全性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=16ef32982072, createdName=经常头晕, createdTime=Mon May 01 13:03:00 CST 2017, time=2017-05-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1901455, encodeId=8d93190145533, content=<a href='/topic/show?id=c097591ed5' target=_blank style='color:#2F92EE;'>#Diabetes#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5917, encryptionId=c097591ed5, topicName=Diabetes)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0045169, createdName=木头人513, createdTime=Sat Nov 26 12:03:00 CST 2016, time=2016-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1798759, encodeId=59ac1e9875946, content=<a href='/topic/show?id=3b62e0402fd' target=_blank style='color:#2F92EE;'>#疗效和安全性研究#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70402, encryptionId=3b62e0402fd, topicName=疗效和安全性研究)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=56ea361, createdName=changhe713, createdTime=Sat May 20 13:03:00 CST 2017, time=2017-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1637473, encodeId=ea18163e473e3, content=<a href='/topic/show?id=afda591646' target=_blank style='color:#2F92EE;'>#DIA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5916, encryptionId=afda591646, topicName=DIA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=987022654425, createdName=ms9608593228839890, createdTime=Fri Jul 28 23:03:00 CST 2017, time=2017-07-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=146582, encodeId=4f4714658222, content=分享一下!, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160817/IMG57B3C3F6DC2FD8753.jpg, createdBy=81321934679, createdName=1e0d99ddm02(暂无匿称), createdTime=Wed Oct 12 11:14:07 CST 2016, time=2016-10-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=146581, encodeId=271414658108, content=分享一下!, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160817/IMG57B3C3F6DC2FD8753.jpg, createdBy=81321934679, createdName=1e0d99ddm02(暂无匿称), createdTime=Wed Oct 12 11:14:00 CST 2016, time=2016-10-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=146580, encodeId=df56146580ee, content=总结的很好!, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160817/IMG57B3C3F6DC2FD8753.jpg, createdBy=81321934679, createdName=1e0d99ddm02(暂无匿称), createdTime=Wed Oct 12 11:13:55 CST 2016, time=2016-10-12, status=1, ipAttribution=)]
    2016-10-12 1e0d99ddm02(暂无匿称)

    总结的很好!

    0

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