在控制 2 型糖尿病方面，替扎帕肽优于长效胰岛素：三项第三阶段随机对照试验的荟萃分析。

IF 4.2 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

International Journal of Obesity Pub Date : 2024-08-29 DOI:10.1038/s41366-024-01621-4

Moein Ala, Razieh Mohammad Jafari, Ahmad Reza Dehpour, Mohammad Poursalehian

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引用次数: 0

摘要

在这项系统综述和荟萃分析中，我们比较了替哌肽与长效或超长效胰岛素治疗 2 型糖尿病的疗效和安全性。我们检索了 PubMed、Web of Science、Scopus 和 Google Scholar 从开始到 2023 年 8 月 20 日的所有文献。纳入了所有比较替扎帕肽与长效或超长效胰岛素治疗 2 型糖尿病疗效的临床试验或随机临床试验。其中包括三项随机临床试验，即 SURPASS-3、SURPASS-4 和 SURPASS-AP-Combo，共有 4339 名患者参加。与每日使用格列奈胰岛素和德格列奈胰岛素相比，每周一次使用替扎帕肽可显著降低 HbA1c（WMD -1.08%，95% CI (-1.37, -0.78)）、餐前 2 小时血糖（BS）（WMD -28.19 mg/dL，95% CI (-44.98, -11.41）、餐前 BS（WMD -11.86 mg/dL，95% CI（-22.83，-0.9））、体重（WMD -10.61 kg，95% CI（-13.24，-7.97））、收缩压（WMD -6.47 mmHg，95% CI（-8.32，-4.61））、舒张压（WMD -2.30毫米汞柱，95% CI（-3.05，-1.55））、总胆固醇（WMD -4.78%，95% CI（-7.05，-2.50））、甘油三酯（WMD -14.49%，95% CI（-19.55，-9.43））、低密度脂蛋白胆固醇（WMD -5.98%，95% CI（-9.83，-2.13））和超低密度脂蛋白胆固醇（WMD -14.18%，95% CI (-19.03，-9.33)）和高密度脂蛋白胆固醇增加（WMD 7.13%，95% CI (-9.83，-2.13)），而 BS ≤ 70 mg/dL 的低血糖风险较低（RR 0.46，95% CI (0.28，0.75)）。所有剂量的每周一次替扎帕肽（5 毫克、10 毫克和 15 毫克）均优于或不劣于胰岛素。在2型糖尿病患者中，一周一次的替扎帕肽可替代长效胰岛素，且疗效更好。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Tirzepatide outcompetes long-acting insulin in managing type 2 diabetes: a meta-analysis of three phase 3 randomized controlled trials.

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Tirzepatide outcompetes long-acting insulin in managing type 2 diabetes: a meta-analysis of three phase 3 randomized controlled trials.

In this systematic review and meta-analysis, we compared the efficacy and safety of tirzepatide with those of long-acting or ultra-long-acting insulin for type 2 diabetes. PubMed, Web of Science, Scopus, and Google Scholar were searched from the inception to August 20, 2023. All clinical trials or randomized clinical trials comparing the efficacy of tirzepatide with long-acting or ultra-long-acting insulin for treating type 2 diabetes were included. Three randomized clinical trials, namely SURPASS-3, SURPASS-4, and SURPASS-AP-Combo, with 4339 patients were included. Compared with daily insulin glargine and degludec, once-weekly tirzepatide significantly decreased HbA1c (WMD -1.08%, 95% CI (-1.37, -0.78)), 2h-posprandial blood sugar (BS) (WMD -28.19 mg/dL, 95% CI (-44.98, -11.41)), pre-meal BS (WMD -11.86 mg/dL, 95% CI (-22.83, -0.9)), body weight (WMD -10.61 kg, 95% CI (-13.24, -7.97)), systolic blood pressure (WMD -6.47 mmHg, 95% CI (-8.32, -4.61)), diastolic blood pressure (WMD -2.30 mmHg, 95% CI (-3.05, -1.55)), total cholesterol (WMD -4.78%, 95% CI (-7.05, -2.50)), triglyceride (WMD -14.49%, 95% CI (-19.55, -9.43)), LDL cholesterol (WMD -5.98%, 95% CI (-9.83, -2.13)), and VLDL cholesterol (WMD -14.18%, 95% CI (-19.03, -9.33)) and increased HDL cholesterol (WMD 7.13%, 95% CI (-9.83, -2.13)), with a lower risk of hypoglycemia defined as BS ≤ 70 mg/dL (RR 0.46, 95% CI (0.28, 0.75)). All doses of once-weekly tirzepatide (5 mg, 10 mg, and 15 mg) were superior or non-inferior to insulin. Once-weekly tirzepatide can be a substitution for long-acting insulin in type 2 diabetes with a greater efficacy.

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来源期刊

International Journal of Obesity 医学-内分泌学与代谢

CiteScore

10.00

自引率

2.00%

发文量

221

审稿时长

3 months

期刊介绍： The International Journal of Obesity is a multi-disciplinary forum for research describing basic, clinical and applied studies in biochemistry, physiology, genetics and nutrition, molecular, metabolic, psychological and epidemiological aspects of obesity and related disorders. We publish a range of content types including original research articles, technical reports, reviews, correspondence and brief communications that elaborate on significant advances in the field and cover topical issues.