Vildagliptin vs liraglutide as a second-line therapy switched from sitagliptin-based regimens in patients with type 2 diabetes: A randomized, parallel-group study.
Vildagliptin vs liraglutide as a second-line therapy switched from sitagliptin-based regimens in patients with type 2 diabetes: A randomized, parallel-group study.
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DOI：
10.1111/jdi.12269
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发表时间：
2015-03
影响因子：
3.2
通讯作者：
Establishment of Rationale for Antiaging Diabetic Medicine (ERA-DM) Study Chapter 2 Group
中科院分区：
文献类型：
--
作者：
Takeshita Y;Takamura T;Kita Y;Otoda T;Kato K;Wakakuri H;Yamada M;Misu H;Matsushima Y;Kaneko S;Establishment of Rationale for Antiaging Diabetic Medicine (ERA-DM) Study Chapter 2 Group
尚未建立基于二肽基肽酶（DPP）-4转运蛋白的方案的递增策略。此外，DPP-4抑制剂和胰高血糖素样肽（GLP）-1受体激动剂之间的相似性和差异仍有待阐明。我们在一项开放标签、随机化临床试验中研究了2型糖尿病患者接受西格列汀治疗方案后，vildagelovine与利拉鲁肽的多效性效应。共有122例西格列汀治疗方案控制不佳的2型糖尿病患者被随机分配至vildagelatin（50 mg，每日两次）或利拉鲁肽（0.9 mg，每日一次）治疗12周。主要结果是糖化血红蛋白和体重指数。在从西格列汀转换后12周内，维达鲁肽和利拉鲁肽均显著降低糖化血红蛋白，但利拉鲁肽的降低幅度更大（−0.67 ± 0.12% vs −0.36 ± 0.53%）。利拉鲁肽降低了体重指数，而维格鲁肽不影响体重指数。维达鲁肽降低空腹C肽免疫反应性，但利拉鲁肽没有。维达利可增加脂联素、花生四烯酸、二十碳五烯酸和二十二碳六烯酸的血清水平，而利拉鲁肽对这些水平无影响。使用糖尿病治疗满意度问卷评估的生活质量在两组中均未受损。最常见的不良事件是胃肠道症状，两组的发生频率相似。维格列汀介导的血糖控制改善与胰岛素分泌和胰岛素敏感性指数无关。从西格列汀转换为利拉鲁肽有助于控制高血糖和体重。每种药物都发挥独特的多效性作用。该试验已在大学医院医学信息网络临床试验注册处注册（编号000004953）。
A step-up strategy for dipeptidyl peptidase (DPP)-4 inhibitor-based regimens has not yet been established. In addition, similarities and differences between DPP-4 inhibitors and glucagon-like peptide (GLP)-1 receptor agonists remain to be elucidated in humans. We investigated the pleiotropic effects of vildagliptin vs liraglutide in patients with type 2 diabetes on sitagliptin-based regimens in an open-label, randomized, clinical trial. A total of 122 patients with type 2 diabetes that was inadequately controlled by sitagliptin-based regimens were randomly assigned to either vildagliptin (50 mg, twice daily) or liraglutide treatment (0.9 mg, once daily) for 12 weeks. The primary outcomes were glycated hemoglobin and body mass index. Both vildagliptin and liraglutide significantly lowered glycated hemoglobin within 12 weeks after switching from sitagliptin, but liraglutide produced a greater reduction (−0.67 ± 0.12% vs −0.36 ± 0.53%). Liraglutide lowered body mass index, whereas vildagliptin did not affect body mass index. Vildagliptin lowered fasting C-peptide immunoreactivity, but liraglutide did not. Vildagliptin increased serum levels of adiponectin, arachidonic acid, eicosapentaenoic acid and docosahexaenoic acid, whereas liraglutide had no effect on these levels. Quality of life, assessed using the diabetes treatment satisfaction questionnaire, was not impaired in either group. The most common adverse events were gastrointestinal symptoms, which occurred with similar frequencies in both groups. Vildagliptin-mediated improvements in glycemic control did not correlate with indices for insulin secretion and insulin sensitivity. Switching from sitagliptin to liraglutide is useful in managing hyperglycemia and weight. Each agent exerts unique pleiotropic effects. This trial was registered with the University Hospital Medical Information Network Clinical Trials Registry (no. 000004953).
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影响因子：
3.7
作者：
Cuthbertson DJ;Irwin A;Gardner CJ;Daousi C;Purewal T;Furlong N;Goenka N;Thomas EL;Adams VL;Pushpakom SP;Pirmohamed M;Kemp GJ
通讯作者：
Kemp GJ
影响因子：
3.2
作者：
Senmaru T;Fukui M;Kobayashi K;Iwase H;Inada S;Okada H;Asano M;Yamazaki M;Hasegawa G;Nakamura N;Iwasaki M;Yabe D;Kurose T;Seino Y
通讯作者：
Seino Y
影响因子：
5.1
作者：
Puavilai, G;Chanprasertyotin, S;Sriphrapradaeng, A
通讯作者：
Sriphrapradaeng, A
影响因子：
5.8
作者：
Esposito, K.;Cozzolino, D.;Giugliano, D.
通讯作者：
Giugliano, D.
影响因子：
16.2
作者：
Rizzo MR;Barbieri M;Marfella R;Paolisso G
通讯作者：
Paolisso G