Clinical Effectiveness of Liraglutide Across Body Mass Index in Patients with Type 2 Diabetes in the United States: A Retrospective Cohort Study
Clinical Effectiveness of Liraglutide Across Body Mass Index in Patients with Type 2 Diabetes in the United States: A Retrospective Cohort Study
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DOI：
10.1007/s12325-014-0153-5
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发表时间：
2014-09-01
影响因子：
3.8
通讯作者：
Hammer, Mette
中科院分区：
文献类型：
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作者：
Chitnis, Abhishek S.;Ganz, Michael L.;Hammer, Mette
临床试验表明，利拉鲁肽可有效降低成年2型糖尿病患者糖化血红蛋白A1c(A1C)水平。然而，在美国，还没有研究通过体重指数(BMI)来评估利拉鲁肽在临床实践中的有效性。这项研究检测了利拉鲁肽在T2D患者中6个月后降低A1C和体重的临床效果。这是一项使用通用电气中心电子病历数据库的回顾性队列研究。选择2010年1月1日至2013年1月31日期间服用利拉鲁肽的T2D(18年的千分之a和BMIa的千分之25 kg/m(2))和A1C>；7%的成年患者，以及在利拉鲁肽开始治疗前12个月未使用胰岛素或胰高血糖素样肽-1类似物的患者(N=3,005)。A1C、体重、A1C和lt较基线的变化(按BMI分层)；6个月后，体重指数25.0~29.9(n=333)、30.0~34.9(n=793)、35.0~39.9(n=821)和百万分之40.0 kg/m(2)(n=1058)A1C水平分别平均下降0.95%、1.02%、0.99%和0.84%(P=0.30)。6个月时A1C和Lt；7%达标率分别为38.2%、37.0%、40.9%和41.0%(P=0.54)。BMI患者的绝对体重降低了1.5~4.0公斤，严重低血糖发生率(0.2%)很低。无论他们的BMI如何，服用利拉鲁肽后，T2D患者的A1C和体重均有统计学意义的降低。在美国的临床实践中，利拉鲁肽在基线BMI上同样有效地降低了A1C。
Clinical trials have shown that liraglutide effectively lowers glycated hemoglobin A1c (A1C) levels in adult patients with type 2 diabetes (T2D). However, no studies have evaluated the effectiveness of liraglutide by body mass index (BMI) in the United States (US) in clinical practice. This study examined liraglutide's clinical effectiveness to lower A1C and body weight after 6 months in T2D patients stratified by baseline BMI.This was a retrospective cohort study using the General Electric Centricity electronic medical records database. Adult patients with T2D (a parts per thousand yen18 years and BMIa parts per thousand yen 25 kg/m(2)) and A1C > 7% at baseline who started liraglutide between January 1, 2010 and January 31, 2013 and who did not use insulin or a glucagon-like peptide-1 analog 12 months before initiating liraglutide (N = 3,005) were selected. Changes from baseline, stratified by BMI, in A1C, body weight, A1C < 7% goal attainment, and incidence of severe hypoglycemia at 6-month follow-up were examined.After 6 months, A1C levels decreased on average by 0.95%, 1.02%, 0.99%, and 0.84% for BMI categories 25.0-29.9 (n = 333), 30.0-34.9 (n = 793), 35.0-39.9 (n = 821), and a parts per thousand yen40.0 kg/m(2) (n = 1,058), respectively (P = 0.30). The proportions of patients achieving A1C < 7% at 6 months were 38.2%, 37.0%, 40.9%, and 41.0% (P = 0.54). The absolute body weight decreased by 1.5 to 4.0 kg across BMI and the rate of severe hypoglycemia (0.2%) was low.Patients with T2D experienced statistically significant decreases in A1C and body weight after initiating liraglutide regardless of their BMI. Liraglutide reduced A1C equally well across baseline BMI in clinical practice in the US.