Comparison of the Efficacy and Tolerability Profile of Liraglutide, a Once-Daily Human GLP-1 Analog, in Patients With Type 2 Diabetes ≥65 and <65 Years of Age: A Pooled Analysis from Phase III Studies

Bruce W. Bode MD , Jason Brett MD , Ali Falahati PhD , Richard E. Pratley MD
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引用次数: 56

Abstract

Background

Managing elderly patients with type 2 diabetes poses particular challenges, so it is important to evaluate the efficacy and tolerability profile of antidiabetic therapies specifically in this patient population.

Objective

The aim of our study was to compare the efficacy and tolerability profile of liraglutide, a GLP-1 analog, in elderly (≥65 years) and younger (<65 years) patients with type 2 diabetes.

Methods

A pooled analysis of 6 randomized, placebo-controlled, multinational trials included data from 3967 patients aged18 to 80 years with type 2 diabetes and glycosylated hemoglobin (HbA1c) of 7% to 11%. Of these, 552 patients ≥65 years received liraglutide 1.8 mg, liraglutide 1.2 mg, or placebo; 2231 patients <65 years received liraglutide 1.8 mg, liraglutide 1.2 mg, or placebo for 26 weeks. End points were: change in HbA1c, fasting plasma glucose, body weight, and blood pressure: as marked to identify elements tracked for change from baseline; hypoglycemic episodes; and adverse events.

Results

Reduction in HbA1c from baseline was significantly greater with liraglutide 1.8 mg versus placebo (least squares mean difference: ≥65 years, 0.91% [95% CI, 0.69–1.12]; <65 years, 1.17% [95% CI, 1.06–1.28]; both, P < 0.0001) and with liraglutide 1.2 mg versus placebo (≥65 years, 0.87% [95% CI, 0.64–1.11]; <65 years, 1.10% [95% CI, 0.98–1.22]; both, P < 0.0001). For fasting plasma glucose, comparable results were observed between liraglutide 1.8 mg or 1.2 mg and placebo for both age groups (P < 0.0001). No statistically significant difference in body weight change was seen with liraglutide between the age groups. The proportion of patients reporting minor hypoglycemia was low and appeared comparable between the ≥65-year-old (4.3%–15.2%) and <65-year-old (8%–13.2%) groups. Likewise, adverse events appeared comparable in nature and frequency.

Conclusion

Liraglutide provides effective glycemic control and is well tolerated in patients ≥65 and <65 years of age with type 2 diabetes. These data suggest that liraglutide may be a suitable treatment option for older patients who may have additional age-related complications.

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利拉鲁肽是一种每日一次的GLP-1类似物,对年龄≥65岁和<65岁的2型糖尿病患者的疗效和耐受性比较:来自III期研究的汇总分析
管理老年2型糖尿病患者面临着特殊的挑战,因此评估抗糖尿病治疗的有效性和耐受性对这一患者群体非常重要。本研究的目的是比较GLP-1类似物利拉鲁肽在老年(≥65岁)和年轻(65岁)2型糖尿病患者中的疗效和耐受性。方法对6项随机、安慰剂对照、多国试验进行汇总分析,包括3967例年龄在18至80岁、糖化血红蛋白(HbA1c)为7%至11%的2型糖尿病患者的数据。其中,552例≥65岁的患者接受利拉鲁肽1.8 mg、1.2 mg或安慰剂治疗;2231例65岁的患者接受利拉鲁肽1.8 mg,利拉鲁肽1.2 mg或安慰剂治疗26周。终点为:HbA1c、空腹血糖、体重和血压的变化:标记以确定从基线开始跟踪变化的元素;低血糖症的发作;以及不良事件。结果:利拉鲁肽1.8 mg组与安慰剂组相比,HbA1c较基线的降低显著更大(最小二乘平均差值:≥65年,0.91% [95% CI, 0.69-1.12];65岁,1.17% [95% CI, 1.06-1.28];都有,P <0.0001),利拉鲁肽1.2 mg vs安慰剂(≥65岁,0.87% [95% CI, 0.64-1.11];65岁,1.10% [95% CI, 0.98-1.22];都有,P <0.0001)。对于空腹血糖,利拉鲁肽1.8 mg或1.2 mg与安慰剂在两个年龄组中观察到相似的结果(P <0.0001)。使用利拉鲁肽后体重变化在不同年龄组间无统计学差异。报告轻度低血糖的患者比例较低,在≥65岁组(4.3%-15.2%)和≥65岁组(8%-13.2%)之间具有可比性。同样,不良事件在性质和频率上也具有可比性。结论利拉鲁肽对≥65岁和65岁的2型糖尿病患者具有有效的血糖控制作用,耐受性良好。这些数据表明利拉鲁肽可能是可能有其他年龄相关并发症的老年患者的合适治疗选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
American Journal Geriatric Pharmacotherapy
American Journal Geriatric Pharmacotherapy GERIATRICS & GERONTOLOGY-PHARMACOLOGY & PHARMACY
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