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CLINICAL EFFICACY AND PREDICTORS OF RESPONSE TO DULAGLUTIDE IN TYPE-2 DIABETES.

Pharmacological Research(2020)

IRCCS MultiMed | Fdn IRCCS Ca Granda | Humanitas Res Hosp | Luigi Sacco Hosp | Univ Pavia

Cited 17|Views28
Abstract
Aim of this retrospective multicenter observational study was to evaluate the efficacy and safety of the glucagon-like peptide-1 receptor agonist (GLP-1 RA) dulaglutide in a type-2 diabetic real-world population and to determine the factors predicting the response in terms of glycated haemoglobin (HbA1c) and other relevant clinical outcomes. Data for efficacy outcomes, adverse events and drug discontinuation were collected from records of patients with type-2 diabetes treated with once-a-week 1.5 mg of dulaglutide for 12 months in routine clinical practice. Initial analysis included 782 patients and 626 had complete follow-up at 6- and 12-months. There was a significant reduction of HbA1c at 6 months (-1 ± 0.8 %, p < 0.0001), which remained stable at 12-months follow-up (-1 ± 0.9 %, p < 0.0001). The percentage of subjects with HbA1c≤7.0 % increased significantly from 7.2 % at baseline to 52.7 % at 6 months to 55.8 % at 12 months. Predictors of the achievement of HbA1c≤7.0 % were low baseline HbA1c and short duration of diabetes. The reduction of HbA1c was associated with reductions of BMI, waist circumference, fasting plasma glucose and blood pressures. Neither sex nor age had significant effects on any clinical or laboratory outcome. The effects of dulaglutide on HbA1c, BMI and SBP tended to be greater in patients who shifted from dipeptidyl peptidase-IV inhibitors (-0.8 ± 0.8 %) than other GLP-1 RA, even if an improvement of HbA1c reduction (-0.5 %) was also seen in those shifting from other GLP-1 RA. This study confirms that addition of dulaglutide 1.5 mg once a week in real word settings has beneficial effects on both clinical and laboratory outcomes in patients with uncontrolled type-2 diabetes. Dulaglutide has a greater effect on HbA1c in patients with higher baseline values and helps achieve a target HbA1c≤7.0 %, more consistently in patients with lower baseline HbA1c and shorter diabetes duration.
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Diabetes treatment,Glucagon-Like peptide-1 receptor agonist,Glycated haemoglobin,Body weight
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要点】:本研究通过回顾性多中心观察,评估了2型糖尿病患者中GLP-1受体激动剂度拉糖肽的疗效和安全性,并确定了预测治疗应答的相关因素。

方法】:研究收集了782例接受每周一次1.5毫克度拉糖肽治疗的2型糖尿病患者病历,对其疗效、不良事件和药物停用情况进行了分析。

实验】:在6个月和12个月时对626名患者进行了完整随访,发现患者HbA1c水平显著降低,从基线到6个月降低了1±0.8%,并在12个月时保持稳定;同时确定了低基线HbA1c和短病程为预测治疗应答的因素。该研究使用的数据集为患者的临床病历记录,结果显示度拉糖肽对HbA1c、BMI和收缩压有改善作用。