胰高血糖素样肽-1受体激动剂治疗2型糖尿病的疗效和安全性:系统综述和混合治疗比较分析
文章的细节
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引用
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Htike ZZ, Zaccardi F, Papamargaritis D, Webb DR, Khunti K, Davies MJ
胰高血糖素样肽-1受体激动剂治疗2型糖尿病的疗效和安全性:系统综述和混合治疗比较分析
《糖尿病与健康杂志》2017年4月19日(4):524-536。doi: 10.1111 / dom.12849。Epub 2017 2月17日。
- PubMed ID
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27981757 (PubMed视图]
- 摘要
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目的:比较胰高血糖素样肽-1受体激动剂(GLP-1RAs)在2型糖尿病患者中的疗效和安全性。材料和方法:我们电子检索了截至2016年6月3日发表的持续24 - 32周的随机临必威国际app床试验,比较了GLP-1RA (albiglutide, dulaglutide,每日两次艾塞那肽和每周一次艾塞那肽,利拉鲁肽,利西塞纳肽,塞莫芦肽和taspoglutide)与安慰剂或另一种GLP-1RA。使用混合治疗比较荟萃分析对心脏代谢和安全性结果的数据进行分析。结果:共有34项试验(14 464名参与者)符合纳入标准;目前尚无关于赛莫芦肽的发表数据。与安慰剂相比,所有GLP-1RAs都降低了糖化血红蛋白(HbA1c)和空腹血糖(FPG)水平(利西塞纳肽分别为-0.55%和-0.73 mmol/L, dulaglutide分别为-1.21%和-1.97 mmol/L)。短效组(每天两次艾塞那肽和利西那肽)和长效组(阿尔比鲁肽、杜拉鲁肽、每周一次艾塞那肽、利拉鲁肽和塔斯普鲁肽)之间没有差异。与每日2次艾塞那肽相比,杜拉鲁肽的HbA1c和FPG降低幅度最大(分别为0.51%和1.04 mmol/L),其次为利拉鲁肽(分别为0.45%和0.93 mmol/L)和艾塞那肽1次(分别为0.38%和0.85 mmol/L);当这3种药物与利西那肽比较时,发现类似的减少。与安慰剂相比,除阿尔比鲁肽外,所有GLP-1RAs均降低了体重,增加了低血糖和胃肠道副作用的风险,除杜拉鲁肽和塔斯普鲁肽外,所有药物均降低了收缩压。 When all GLP-1RAs were compared with each other, no clinically meaningful differences were observed in weight loss, blood pressure reduction or hypoglycaemia risk. Albiglutide had the lowest risk of nausea and diarrhoea and once-weekly exenatide the lowest risk of vomiting. CONCLUSIONS: The RCTs in the present analysis show that all GLP-1RAs improve glycaemic control, reduce body weight and increase the risk of adverse gastrointestinal symptoms compared with placebo. Although there were no differences when short-acting agents were compared with each other or when long-acting agents were compared with each other, dulaglutide, liraglutide and once-weekly exenatide were superior to twice-daily exenatide and lixisenatide at lowering HbA1c and FPG levels. There were no differences in hypoglycaemia between these 3 agents, whilst once-weekly exenatide had the lowest risk of vomiting. These results, along with patient's preferences and individualized targets, should be considered when selecting a GLP-1RA.
引用本文的药物库数据
- 药物靶点
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药物 目标 种类 生物 药理作用 行动 Albiglutide 胰高血糖素样肽1受体 蛋白质 人类 是的受体激动剂细节 Dulaglutide 胰高血糖素样肽1受体 蛋白质 人类 是的受体激动剂细节 Exenatide 胰高血糖素样肽1受体 蛋白质 人类 是的受体激动剂细节 Lixisenatide 胰高血糖素样肽1受体 蛋白质 人类 是的受体激动剂细节 Semaglutide 胰高血糖素样肽1受体 蛋白质 人类 是的受体激动剂细节 Taspoglutide 胰高血糖素样肽1受体 蛋白质 人类 是的受体激动剂细节