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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 ONE)

2016-09-19 Seven L译 MedSci原创

目的:研究对象为1型糖尿病患者,调查在胰岛素靶向治疗基础上,添加利拉鲁肽,能否改善患者的血糖控制、减少胰岛素需求和体重。 方法:本项为期52周的双盲试验纳入了1398例1型糖尿病成人患者,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;所有患者同时使用胰岛素治疗。 结果;基线HbA1c水平为8.2% (66 mmol/mol),治疗结束后Hb

目的:研究对象为1型糖尿病患者,调查在胰岛素靶向治疗基础上,添加利拉鲁肽,能否改善患者的血糖控制、减少胰岛素需求和体重。

方法:本项为期52周的双盲试验纳入了1398例1型糖尿病成人患者,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;所有患者同时使用胰岛素治疗。

结果;基线HbA1c水平为8.2% (66 mmol/mol),治疗结束后HbA1c水平下降0.34–0.54% (3.7–5.9 mmol/mol);利拉鲁肽1.8 mg和1.2 mg组与安慰剂组相比,HbA1c水平下降更多(估计治疗差异[ETDs]: 1.8 mg组  −0.20% [95% CI −0.32; −0.07]; 1.2 mg组 −0.15% [95% CI −0.27; −0.03]; 0.6 mg组 −0.09% [95% CI −0.21; 0.03])。

利拉鲁肽1.8 mg和1.2 mg组与安慰剂组相比,胰岛素需求量下降(估计治疗比率:1.8 mg组 0.92 [95% CI 0.88; 0.96]; 1.2 mg组 0.95 [95% CI 0.91; 0.99]; 0.6 mg组 1.00 [95% CI 0.96; 1.04])。

所有剂量利拉鲁肽组与安慰剂组相比,平均体重下降更多(ETDs:1.8 mg组 −4.9 kg [95% CI −5.7; −4.2]; 1.2 mg组 −3.6 kg [95% CI −4.3; −2.8]; 0.6 mg组 −2.2 kg [95% CI −2.9; −1.5])。

所有剂量利拉鲁肽组的症状性低血糖发生率增加(估计RR:1.8 mg组 1.31 [95% CI 1.07; 1.59]; 1.2 mg组 1.27 [95% CI 1.03; 1.55]; 0.6 mg组 1.17 [95% CI 0.97; 1.43]);利拉鲁肽1.8 mg组患者的伴酮症高血糖发生率显著增加(事件RR 2.22 [95% CI 1.13; 4.34])。

结论:对于1型糖尿病成人患者,在胰岛素治疗基础上添加利拉鲁肽,可以降低HbA1c水平、总胰岛素需求量和体重;但会增加症性低血糖和伴酮症高血糖的发生率;从而限制了利拉鲁肽对这类患者的临床应用。

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    2017-03-31 柳叶一刀
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  5. [GetPortalCommentsPageByObjectIdResponse(id=1637476, encodeId=3ee9163e4762e, content=<a href='/topic/show?id=afda591646' target=_blank style='color:#2F92EE;'>#DIA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, 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=Sat Feb 11 18:03:00 CST 2017, time=2017-02-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1759765, encodeId=55661e5976524, content=<a href='/topic/show?id=9bea33520d' target=_blank style='color:#2F92EE;'>#BET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3352, encryptionId=9bea33520d, topicName=BET)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Fri Mar 31 15:03:00 CST 2017, time=2017-03-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1798760, encodeId=df3c1e98760c4, 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=79, 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=Fri Jun 16 00:03:00 CST 2017, time=2017-06-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1901458, encodeId=897a1901458ff, content=<a href='/topic/show?id=c097591ed5' target=_blank style='color:#2F92EE;'>#Diabetes#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, 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=Wed Jun 07 20:03:00 CST 2017, time=2017-06-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1720804, encodeId=e3171e208040c, 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=68, 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=Fri Jan 20 19:03:00 CST 2017, time=2017-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=146591, encodeId=2f561465919e, content=总结的很好!, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, 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 11:15:23 CST 2016, time=2016-10-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=146590, encodeId=a07314659029, content=分享一下!, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, 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 11:15:17 CST 2016, time=2016-10-12, status=1, ipAttribution=)]
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    2016-10-12 1e0d99ddm02(暂无匿称)

    总结的很好!

    0

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    2016-10-12 1e0d99ddm02(暂无匿称)

    分享一下!

    0

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β阻滞剂在怀孕期间被广泛应用于治疗高血压疾病。这些药物穿过胎盘,可能导致子宫内新生儿的生理变化。在一项全国性队列研究中,研究人员试图确定在母体内暴露β阻滞剂与新生儿低血糖和心动过缓风险之间的联系。 研究人员链接到2292116名活产婴儿的数据,他们的妈妈在2003年至2007年期间被招募参与此研究。研究人员检查了新生儿低血糖和心动过缓风险与在母体内暴露β受体阻断剂之间的联系。倾向评分匹配

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