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首页> 外文期刊>Journal of Clinical Medicine Research >Factors Associated With Reduced Efficacy of Sitagliptin Therapy: Analysis of 93 Patients With Type 2 Diabetes Treated for 1.5 Years or Longer
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Factors Associated With Reduced Efficacy of Sitagliptin Therapy: Analysis of 93 Patients With Type 2 Diabetes Treated for 1.5 Years or Longer

机译：西他列汀治疗效果降低的相关因素：治疗1。5年或更长时间的93例2型糖尿病患者的分析

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Background: Several studies have shown the effectiveness of sitagliptin, a dipeptidyl peptidase-4 inhibitor, for type 2 diabetes, with a hypoglycemic effect being demonstrated both when it is administered alone or in combination with other oral antidiabetic agents. However, there are few reports about its long-term efficacy, although medications for diabetes need to be effective over the long term. This study (as part of ASSET-K) aimed to investigate the efficacy and safety of sitagliptin when it was administered for 1.5 years or longer, and to explore factors associated with reduction of the therapeutic response.Methods: Out of 375 patients treated with sitagliptin (50 mg/day) at Kanamori Diabetes Clinic between December 2009 and March 2012, 133 could be followed up for 72 weeks without interruption. After excluding 40 patients in whom the dosage and/or types of concomitant medications were modified during that period, the remaining 93 were included in this analysis. Clinical indices, such as blood glucose, HbA1c, and body weight, were investigated retrospectively. Compliance with diet and exercise therapy at 48 weeks was checked by a questionnaire.Results: In the 93 patients analyzed (sitagliptin monotherapy, n = 9; combination therapy, n = 77; and switching from an alpha-glucosidase inhibitor or glinide, n = 7), hemoglobin A1c (HbA1c) showed a significant decrease after 24 weeks (7.70 ± 0.73% at baseline vs. 6.90 ± 0.55% at 24 weeks), but then showed a slight increase at 48 weeks. HbA1c was subsequently maintained in the same range with no significant changes until 72 weeks. A positive correlation was noted between the changes of HbA1c and body weight from 24 to 48 weeks. Compliance with diet and exercise therapy was worse in patients showing a ≥ 0.3% increase of HbA1c (n = 37) from 24 to 48 weeks than in the others (n = 56). Multiple logistic regression analysis showed that both factors were independent determinants of the increase of HbA1c from 24 weeks onward.Conclusions: Sitagliptin showed good efficacy and safety when administered for 18 months as both monotherapy and combination therapy. Inadequate compliance with diet/exercise therapy and weight again may be associated with an increase of HbA1c over time during treatment with sitagliptin.doi: http://dx.doi.org/10.4021/jocmr1256w
机译：背景：多项研究表明，西他列汀（一种二肽基肽酶4抑制剂）对2型糖尿病有效，单独或与其他口服降糖药联合使用时，均显示出降血糖作用。但是，尽管需要长期有效的糖尿病药物治疗，但很少有关于其长期疗效的报道。这项研究（作为ASSET-K的一部分）旨在研究西他列汀给药1.5年或更长时间的疗效和安全性，并探讨与西他列汀治疗疗效降低相关的因素。方法：在375名接受西他列汀治疗的患者中（2009年12月至2012年3月）在Kanamori糖尿病诊所（50 mg /天），可以连续133周随访133次，而不会中断。在排除40例在此期间修改了用药剂量和/或类型的患者后，其余93例纳入了该分析。回顾性研究了临床指标，例如血糖，HbA1c和体重。通过问卷调查在48周时饮食和运动疗法的依从性。结果：在分析的93例患者中（西他列汀单药治疗，n = 9;联合治疗，n = 77;以及从α-葡萄糖苷酶抑制剂或glinide换用，n = 7），血红蛋白A1c（HbA1c）在24周后显示出显着下降（基线时为7.70±0.73％，而在24周时为6.90±0.55％），但在48周时略有增加。随后将HbA1c维持在相同的范围内，直到72周前无明显变化。 HbA1c的变化与体重在24至48周之间呈正相关。在24至48周内，HbA1c增加（≥37）≥0.3％的患者（n = 56）对饮食和运动疗法的依从性较差。多元logistic回归分析表明，从24周开始，这两个因素都是HbA1c升高的独立决定因素。结论：西他列汀单药治疗和联合治疗18个月时均显示出良好的疗效和安全性。饮食/运动疗法依从性不足以及体重再增加可能与西他列汀治疗期间HbA1c随时间增加有关。doi：http://dx.doi.org/10.4021/jocmr1256w

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