A randomised, double-blind, trial of the safety and efficacy of omarigliptin (a once-weekly DPP-4 inhibitor) in subjects with type 2 diabetes and renal impairment

作者:Chacra Antonio; Gantz Ira*; Mendizabal Geraldine; Durlach Lucila; O'Neill Edward A; Zimmer Zachary; Suryawanshi Shailaja; Engel Samuel S; Lai Eseng
来源:International Journal of Clinical Practice, 2017, 71(6): e12955.
DOI:10.1111/ijcp.12955

摘要

Aims: To assess the safety and efficacy of omarigliptin in subjects with type 2 diabetes mellitus (T2DM) and chronic renal impairment (RI). Methods: Patients with T2DM with moderate RI (estimated glomerular filtration rate [eGFR] >= 30 to <60 mL/min/1.73 m(2)) (N=114), severe RI (eGFR <30 mL/min/1.73 m(2)) (N= 55) or end-stage renal disease on dialysis (N= 44), who were either not on an antihyperglycaemic agent therapy for at least 12 weeks at screening, washed-off of oral antihyperglycaemic agent monotherapy or low-dose dual combination therapy, or on insulin monotherapy, with baseline glycated haemoglobin (HbA1c) of 6.5%-10.0% were randomised to omarigliptin or to placebo for 24 weeks (primary end-point) followed by a 30-week period with subjects on placebo switched to blinded glipizide (if not on insulin). Results: After 24 weeks, from a mean baseline HbA1c of 8.4% in the omarigliptin group and 8.3% in the placebo group, the least squares mean (95% CI) change from baseline in HbA1c in the overall population (all renal strata combined) was -0.77% (-1.00 to -0.54) in the omarigliptin group and -0.44% (-0.67 to -0.21) in the placebo group; between-group difference of -0.33% (-0.63 to -0.02); P=0.035. After 24 weeks, the incidences of subjects with symptomatic hypoglycaemia, one or more adverse event (AE), drug-related AE, serious AE and discontinuation due to an AE were similar in the omarigliptin and placebo groups. Conclusions: In this study in subjects with T2DM and RI, relative to placebo, omarigliptin provided clinically meaningful reductions in HbA1c, had a similar incidence of symptomatic hypoglycaemia and was generally well tolerated.

  • 出版日期2017-6