疗效和安全性的glucagon-like peptide-1受体受体激动剂在2型糖尿病:系统回顾和mixed-treatment比较分析。

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着ZZ, Zaccardi F, Papamargaritis D,韦伯博士这样K,戴维斯乔丹

疗效和安全性的glucagon-like peptide-1受体受体激动剂在2型糖尿病:系统回顾和mixed-treatment比较分析。

糖尿病ob金属底座。2017年4月,19 (4):524 - 536。doi: 10.1111 / dom.12849。Epub 2017年2月17日。

PubMed ID

27981757 (在PubMed

]

文摘

目的:比较疗效和安全性的glucagon-like peptide-1受体受体激动剂(GLP-1RAs)在2型糖尿病患者。材料和方法:我们电子搜索,到6月3日,2016年发表的随机临床试验持续从24到32周,相比GLP-1RA (albiglutide dulaglutide,每天exenatide和每周exenatide liraglutide, lixisenatide, semaglutide和taspoglutide)与安慰剂或其他GLP-1RA。代谢疾病数据和安全使用mixed-treatment比较分析结果进行了分析。结果:共有34个试验(14 464名参与者)满足入选标准;没有可用semaglutide发表的数据。与安慰剂相比,所有GLP-1RAs降低糖化血红蛋白(HbA1c)和空腹血浆葡萄糖(台塑)水平(包括减少-0.55%和-0.73更易/ L,分别为lixisenatide -1.21%和-1.97更易/ L,分别为dulaglutide)。没有差异短效(每天exenatide和lixisenatide)或长效(albiglutide dulaglutide,每周exenatide, liraglutide和taspoglutide)组。相比之下,每天exenatide dulaglutide治疗与最大的降低糖化血红蛋白和台塑(分别为0.51%和1.04更易/ L),其次是liraglutide(分别为0.45%和0.93更易/ L)和每周exenatide(分别为0.38%和0.85更易/ L);类似的减少被发现当这些与lixisenatide相比3剂。与安慰剂相比,所有GLP-1RAs除了albiglutide减少体重和增加低血糖的风险和胃肠道副作用,和所有代理除了dulaglutide taspoglutide收缩压降低。 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.

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药物靶点

药物	目标	类	生物	药理作用	行动
Albiglutide	Glucagon-like肽受体1	蛋白质	人类	是的	受体激动剂	细节
Dulaglutide	Glucagon-like肽受体1	蛋白质	人类	是的	受体激动剂	细节
Exenatide	Glucagon-like肽受体1	蛋白质	人类	是的	受体激动剂	细节
Lixisenatide	Glucagon-like肽受体1	蛋白质	人类	是的	受体激动剂	细节
Semaglutide	Glucagon-like肽受体1	蛋白质	人类	是的	受体激动剂	细节
Taspoglutide	Glucagon-like肽受体1	蛋白质	人类	是的	受体激动剂	细节