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首页> 外文期刊>The Journal of Clinical Pharmacology: Official Journal of the American College of Clinical Pharmacology >A drug and disease model for lixisenatide, a GLP-1 receptor agonist in type 2 diabetes
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A drug and disease model for lixisenatide, a GLP-1 receptor agonist in type 2 diabetes

机译:利西拉肽(一种2型糖尿病的GLP-1受体激动剂)的药物和疾病模型

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摘要

Incretin hormone analogs such as glucagon-like peptide-1 (GLP-1) receptor agonists have emerged as promising new options for the treatment of type 2 diabetes mellitus (T2DM), targeting several of its pathophysiological traits, including reduced insulin sensitivity, inadequate insulin secretion, and loss of β-cell mass (BCM). This article describes the semi-mechanistic modeling of lixisenatide dose-response over time using fasting plasma glucose (FPG), fasting serum insulin (FSI) and glycated hemoglobin (HbA1c) data from two Phase II and four Phase III clinical trials, for a total of 2470 T2DM patients. Previously published models for FPG, FSI, and BCM as well as HbA1c were adapted and expanded to describe the available data. The model incorporated aspects describing disease progression, standard-of-care, FPG-dependent and -independent HbA1c synthesis, and covariate effects of body size, race, and sex. The final model described lixisenatide effects on β-cell responsiveness, insulin sensitivity and FPG-independent HbA1c synthesis, was able to describe the observed FPG, FSI, and HbA1c data accurately, and was successful in predicting data from an unseen Phase III clinical study.
机译:胰高血糖素激素类似物,例如胰高血糖素样肽1(GLP-1)受体激动剂,已成为治疗2型糖尿病(T2DM)的有希望的新选择,针对其几种病理生理特征,包括降低的胰岛素敏感性,胰岛素不足分泌和β细胞团块(BCM)丢失。本文介绍了使用空腹血糖(FPG),空腹血清胰岛素(FSI)和糖化血红蛋白(HbA1c)数据进行的两个II期和4期III期临床试验随时间变化的利西拉肽剂量-反应的半力学建模2470名T2DM患者。 FPG,FSI和BCM以及HbA1c的先前发布的模型进行了调整和扩展,以描述可用数据。该模型结合了以下方面:疾病进展,护理标准,FPG依赖性和非依赖性HbA1c合成,以及体型,种族和性别的协变量效应。最终模型描述了利西拉肽对β细胞反应性,胰岛素敏感性和不依赖FPG的HbA1c合成的影响,能够准确描述观察到的FPG,FSI和HbA1c数据,并且成功地预测了来自未见的III期临床研究的数据。

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