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NEJM:利拉鲁肽可降低2型糖尿病的心血管风险?

2016-06-14 Seven L 译 MedSci原创

在2型糖尿病患者的标准治疗中加入利拉鲁肽,会对患者的心血管产生什么影响呢?目前仍不知道。因此研究者对2型糖尿病和心血管疾病高风险患者接受利拉鲁肽或安慰剂进行了一项双盲试验。以第一次出现心血管原因死亡、非致死性心肌梗死或非致死性卒中为要复合终点的时间事件分析。该研究纳入了9340名患者,利拉鲁肽和安慰剂组分别有4668人和4672人。中位数随访时间3.8年里,利拉鲁肽组的主要结局发生率低于安慰剂组(

在2型糖尿病患者的标准治疗中加入利拉鲁肽,会对患者的心血管产生什么影响呢?目前仍不知道。

因此研究者对2型糖尿病和心血管疾病高风险患者接受利拉鲁肽或安慰剂进行了一项双盲试验。以第一次出现心血管原因死亡、非致死性心肌梗死或非致死性卒中为要复合终点的时间事件分析。

该研究纳入了9340名患者,利拉鲁肽和安慰剂组分别有4668人和4672人。中位数随访时间3.8年里,利拉鲁肽组的主要结局发生率低于安慰剂组(608[13.0%] vs. 694[14.9%];HR, 0.87; 95% CI, 0.78 - 0.97; 非劣性P<0.001;优越性P=0.01 )。利拉鲁肽组的心血管原因死亡也更少(219[4.7%] vs. 278[6.0%];HR, 0.78; 95% CI, 0.66 - 0.93; P=0.007)。全因死亡率在利拉鲁肽组也更低(381[8.2%] vs. 447 [9.6%];HR, 0.85; 95% CI, 0.74 - 0.97; P=0.02)。利拉鲁肽组相比安慰剂组,非致死性心肌梗死、非致死性卒中、心衰住院方面没有差异。导致利拉鲁肽停药的最常见不良事件是胃肠道事件。胰腺炎发病率在两组无差异。

研究结果表明,2型糖尿病患者使用利拉鲁肽与安慰剂相比,第一次出现心血管原因死亡、非致死性心肌梗死或非致死性卒中等的复合终点发生率更低。

原始出处:


Steven P. Marso, Gilbert H. Daniels,et al.Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes.NEJM.June 13, 2016DOI: 10.1056/NEJMoa1603827


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  1. [GetPortalCommentsPageByObjectIdResponse(id=132166, encodeId=7dab1321664a, content=文章很好,非常有益, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Wed Sep 21 08:44:00 CST 2016, time=2016-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=132168, encodeId=1690132168a9, content=文章很好,非常有益, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Wed Sep 21 08:44:00 CST 2016, time=2016-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=127449, encodeId=e58512e44982, content=好药好疗效, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160907/IMG57D00CF1965701770.jpg, createdBy=565c1948251, createdName=舒心和人, createdTime=Thu Sep 15 13:26:00 CST 2016, time=2016-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2082378, encodeId=78cf20823e8e1, content=<a href='/topic/show?id=56658981223' target=_blank style='color:#2F92EE;'>#血管风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89812, encryptionId=56658981223, topicName=血管风险)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/101296147/78FA0899509C358B01B975E8EAC1F88A/100, createdBy=7d822500145, createdName=ms5353107019656438, createdTime=Fri Mar 17 20:45:00 CST 2017, time=2017-03-17, status=1, ipAttribution=)]
    2016-09-21 1e10c84am36(暂无匿称)

    文章很好,非常有益

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=132166, encodeId=7dab1321664a, content=文章很好,非常有益, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Wed Sep 21 08:44:00 CST 2016, time=2016-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=132168, encodeId=1690132168a9, content=文章很好,非常有益, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Wed Sep 21 08:44:00 CST 2016, time=2016-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=127449, encodeId=e58512e44982, content=好药好疗效, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160907/IMG57D00CF1965701770.jpg, createdBy=565c1948251, createdName=舒心和人, createdTime=Thu Sep 15 13:26:00 CST 2016, time=2016-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2082378, encodeId=78cf20823e8e1, content=<a href='/topic/show?id=56658981223' target=_blank style='color:#2F92EE;'>#血管风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89812, encryptionId=56658981223, topicName=血管风险)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/101296147/78FA0899509C358B01B975E8EAC1F88A/100, createdBy=7d822500145, createdName=ms5353107019656438, createdTime=Fri Mar 17 20:45:00 CST 2017, time=2017-03-17, status=1, ipAttribution=)]
    2016-09-21 1e10c84am36(暂无匿称)

    文章很好,非常有益

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=132166, encodeId=7dab1321664a, content=文章很好,非常有益, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Wed Sep 21 08:44:00 CST 2016, time=2016-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=132168, encodeId=1690132168a9, content=文章很好,非常有益, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Wed Sep 21 08:44:00 CST 2016, time=2016-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=127449, encodeId=e58512e44982, content=好药好疗效, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160907/IMG57D00CF1965701770.jpg, createdBy=565c1948251, createdName=舒心和人, createdTime=Thu Sep 15 13:26:00 CST 2016, time=2016-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2082378, encodeId=78cf20823e8e1, content=<a href='/topic/show?id=56658981223' target=_blank style='color:#2F92EE;'>#血管风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89812, encryptionId=56658981223, topicName=血管风险)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/101296147/78FA0899509C358B01B975E8EAC1F88A/100, createdBy=7d822500145, createdName=ms5353107019656438, createdTime=Fri Mar 17 20:45:00 CST 2017, time=2017-03-17, status=1, ipAttribution=)]
    2016-09-15 舒心和人

    好药好疗效

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=132166, encodeId=7dab1321664a, content=文章很好,非常有益, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Wed Sep 21 08:44:00 CST 2016, time=2016-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=132168, encodeId=1690132168a9, content=文章很好,非常有益, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Wed Sep 21 08:44:00 CST 2016, time=2016-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=127449, encodeId=e58512e44982, content=好药好疗效, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160907/IMG57D00CF1965701770.jpg, createdBy=565c1948251, createdName=舒心和人, createdTime=Thu Sep 15 13:26:00 CST 2016, time=2016-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2082378, encodeId=78cf20823e8e1, content=<a href='/topic/show?id=56658981223' target=_blank style='color:#2F92EE;'>#血管风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89812, encryptionId=56658981223, topicName=血管风险)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/101296147/78FA0899509C358B01B975E8EAC1F88A/100, createdBy=7d822500145, createdName=ms5353107019656438, createdTime=Fri Mar 17 20:45:00 CST 2017, time=2017-03-17, status=1, ipAttribution=)]

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