Glucagon-like peptide-1 receptor agonists in type 2 diabetes:a meta-analysis of randomized clinical trials
发布日期：2010-05-11 17:21 文章来源：<a href='http://www.dxy.cn'>丁香园</a>
关键词： 诺和诺德
GLP-1
肠促胰素
利拉鲁肽
点击次数：
最近发表于《European Journal of Endocrinology》的文章报道，一项纳入了21项随机对照试验、 3,053名患者的荟萃分析结果显示，GLP-1激动剂改善HbA1c和餐后血糖的效果更好，低血糖风险更小，心血管事件也没有增加。
对于磺脲类和双胍类药物治疗效果不佳的患者，继用GLP-1激动剂的效果可与胰岛素媲美。目前的数据也显示，每日一次使用的liraglutide的耐受性和有效性不逊于每日两次的exenatide。
OBJECTIVE：
The role of Glucagon-Like Peptide-1 (GLP-1) receptor agonists in the treatment of type 2 diabetes is debated; many recent trials, which were not included in previous meta-analyses, could add relevant information.
DESIGN AND METHODS：
All available randomized controlled trials (RCTs), either published or unpublished, performed in type 2 diabetic patients with GLP-1 receptor agonists (exenatide and liraglutide), with a duration>12 weeks were meta-analysed for HbA1c, BMI, hypoglycaemia, and other adverse events.
RESULTS AND CONCLUSIONS：
A total of 21 RCTs (6 of which unpublished), enrolling 5,429 and 3,053 patients (with GLP-1 receptor agonists and active comparator or placebo, respectively), was retrieved and included in the analysis. GLP-1 receptor agonists determine a significant improvement of HbA1c in comparison with placebo (-1.0[-1.1:-0.8], p<0.001), with a low risk of hypoglycaemia. There is no evidence of increased cardiovascular risk with the use of GLP-1 receptor agonists. GLP-1 receptor agonists, which induce weight loss, are associated with gastrointestinal side effects. GLP-1 receptor agonists are effective in reducing HbA1c and postprandial glucose. In patients failing to sulphonylureas and/or metformin, GLP-1 receptor agonists are similarly effective as insulin. Available data suggest that the efficacy and tolerability of the novel agent, liraglutide, which is adequate for once-a-day administration, are comparable to those of exenatide bis in die.
编辑: helen