1660-P：替唑帕肽治疗 1 型糖尿病成人肥胖症的疗效和安全性--梅奥诊所的经验

IF 6.2 1区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes Pub Date : 2024-06-21 DOI:10.2337/db24-1660-p

ELIF TAMA, DIMA BECHENATI, PAMELA BENNETT, ALLYSON MCNALLY, RENE RIVERA, SIMA FANSA, DIEGO ANAZCO, ANDRES ACOSTA, MARIA D. HURTADO

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引用次数: 0

摘要

简介：替扎帕肽治疗超重/肥胖症的疗效和安全性已在 2 型糖尿病（T1D）成人患者中得到广泛认可，但在 1 型糖尿病（T1D）患者中尚未得到认可。我们旨在评估替扎帕肽治疗成人 T1D 患者肥胖症的疗效和安全性。研究方法这是一项回顾性研究，研究对象为使用替扎帕肽治疗肥胖症的成年 T1D 患者。排除标准：使用替扎帕肽达<3个月、使用其他抗肥胖药物和活动性恶性肿瘤。终点：治疗3个月、6个月和12个月时的总体重减轻（TBWL）百分比；TBWL百分比；从基线到最后随访期间HbA1c、胰岛素日总剂量[TDD]和连续血糖监测参数（分别为在范围内、高于范围和低于范围的时间[TIR、TAR和TBR]）的变化；副作用、严重低血糖和糖尿病酮症酸中毒（DKA）的发生率。我们采用配对 t 检验来分析数据。数据以中位数[IQR]表示。结果我们纳入了 52 名患者：58%为女性，98%为白人，年龄 50 岁 [39-58]，体重指数 36 kg/m2 [32-42]。3、6和12个月时的TBWL分别为6% [3-9]（n=44）、8% [5-15]（n=29）和14% [7-22]（n=13）（均为p<0.001）。从基线到最后一次随访，中位时间为 6 个月 [4-11]，TBWL% 下降了 8% [5-14]，Hba1c 下降了 1% [0.2-1.8]，TDD 下降了 32% [6-45]，TAR 下降了 28% [8-48]，所有数据均为 p<0.001。TIR 增加了 29% [3-55]，p<0.001。TBR 有下降的趋势，降幅为 32% [0-78]，p=0.08。没有发生严重低血糖或 DKA 的记录。副作用发生率为 26%，最常见的是恶心（15%）。两名患者（4%）因副作用而停止服用替扎帕肽。结论对于患有 T1D 的成人患者，在长达 12 个月的治疗过程中，替扎帕肽可显著减轻体重，改善糖尿病控制，降低胰岛素需求量，但不会导致严重低血糖或 DKA。其副作用与已报道的相似。这些数据支持替扎帕肽治疗成人 T1D 患者肥胖症的有效性和安全性。披露 E. Tama：无。D. Bechenati：无：无。P. Bennett：礼来糖尿病公司股票/股东。A. McNally：美敦力公司股票/股东。R. Rivera：无。S. Fansa：无。D. Anazco：无。A. Acosta：顾问；安进公司、Regeneron 制药公司、雀巢健康科学公司、Structure Therapeutics 公司、勃林格殷格翰公司。研究支持；Vivus。顾问；Currax.其他关系；Gila Therapeutics、Phenomix Sciences。演讲人办公室；礼来公司。赫尔塔多医学博士：无。资助 K12AR084222

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1660-P: Efficacy and Safety of Tirzepatide for the Treatment of Obesity in Adults with Type 1 Diabetes—The Mayo Clinic Experience

Introduction: The efficacy and safety of tirzepatide for the treatment of overweight/obesity are well established in adults with type 2, but not type 1, diabetes (T1D). We aim to evaluate the efficacy and safety of tirzepatide for the treatment of obesity in adults with T1D. Methods: This is a retrospective study of adults with T1D treated with tirzepatide for obesity. Exclusion criteria: tirzepatide use for <3 months, use of other antiobesity medications, and active malignancy. Endpoints: total body weight loss (TBWL) percentage at 3, 6, and 12 months of treatment; TBWL%, change in HbA1c, total daily insulin dose [TDD], and continuous glucose monitor parameters (time in-, above-, and below range [TIR, TAR, and TBR, respectively]) from baseline to last-follow-up; and incidence of side effects, severe hypoglycemia, and diabetes ketoacidosis (DKA). We used matched pair t-test to analyze data. Data are presented as median [IQR]. Results: We included 52 patients: 58% female, 98% White, age 50 years [39-58], BMI 36 kg/m2 [32-42]. TBWL at 3, 6, and 12 months was 6% [3-9] (n=44), 8% [5-15] (n=29), and 14% [7-22] (n=13), respectively (p<0.001 for all). From baseline to the last follow up, median time of 6 months [4-11], TBWL% decreased by 8% [5-14], Hba1c by 1% [0.2-1.8], TDD by 32% [6-45], and TAR by 28% [8-48], p<0.001 for all. TIR increased by 29% [3-55], p<0.001. There was a trend for a decrease in TBR of 32% [0-78], p=0.08. No episodes of severe hypoglycemia or DKA were recorded. The incidence of side effects was 26%, the most common was nausea (15%). Two patients (4%) discontinued tirzepatide due to side effects. Conclusion: In adults with T1D, tirzepatide led to significant weight loss, better diabetes control, and lower insulin requirements without causing severe hypoglycemia or DKA over the course of up to 12 months. The side effect profile mimicked what has been reported. These data support the effectiveness and safety of tirzepatide for the treatment of obesity in adults with T1D. Disclosure E. Tama: None. D. Bechenati: None. P. Bennett: Stock/Shareholder; Lilly Diabetes. A. McNally: Stock/Shareholder; Medtronic. R. Rivera: None. S. Fansa: None. D. Anazco: None. A. Acosta: Consultant; Amgen Inc., Regeneron Pharmaceuticals Inc., Nestlé Health Science, Structure Therapeutics, Inc., Boehringer-Ingelheim. Research Support; Vivus. Consultant; Currax. Other Relationship; Gila Therapeutics, Phenomix Sciences. Speaker's Bureau; Eli Lilly and Company. M.D. Hurtado: None. Funding K12AR084222

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来源期刊

Diabetes 医学-内分泌学与代谢

CiteScore

12.50

自引率

2.60%

发文量

1968

审稿时长

1 months

期刊介绍： Diabetes is a scientific journal that publishes original research exploring the physiological and pathophysiological aspects of diabetes mellitus. We encourage submissions of manuscripts pertaining to laboratory, animal, or human research, covering a wide range of topics. Our primary focus is on investigative reports investigating various aspects such as the development and progression of diabetes, along with its associated complications. We also welcome studies delving into normal and pathological pancreatic islet function and intermediary metabolism, as well as exploring the mechanisms of drug and hormone action from a pharmacological perspective. Additionally, we encourage submissions that delve into the biochemical and molecular aspects of both normal and abnormal biological processes. However, it is important to note that we do not publish studies relating to diabetes education or the application of accepted therapeutic and diagnostic approaches to patients with diabetes mellitus. Our aim is to provide a platform for research that contributes to advancing our understanding of the underlying mechanisms and processes of diabetes.