Liraglutide enhances insulin secretion and prolongs the remission period in adults with newly diagnosed type 1 diabetes (the NewLira study): A randomized, double-blind, placebo-controlled trial

被引:9
作者
Dejgaard, Thomas F. [1 ,2 ,3 ]
Frandsen, Christian S. [4 ]
Kielgast, Urd [5 ]
Storling, Joachim [1 ,6 ]
Overgaard, Anne J. [1 ]
Svane, Maria S. [4 ]
Olsen, Markus Harboe [7 ,8 ]
Thorsteinsson, Birger [3 ]
Andersen, Henrik U. [1 ]
Krarup, Thure [9 ,10 ]
Holst, Jens J. [6 ,11 ]
Madsbad, Sten [4 ]
机构
[1] Steno Diabet Ctr Copenhagen, Herlev, Denmark
[2] Univ Copenhagen, Gentofte Hosp, Ctr Clin Metab Res, Hellerup, Denmark
[3] Copenhagen Univ Hosp Nordsjaelland, Dept Endocrinol & Nephrol, Hillerod, Denmark
[4] Copenhagen Univ Hosp Hvidovre, Dept Endocrinol, DK-2650 Hvidovre, Denmark
[5] Copenhagen Univ Hosp Zealand, Dept Endocrinol, Koege, Denmark
[6] Univ Copenhagen, Dept Biomed Sci, Copenhagen, Denmark
[7] Copenhagen Univ Hosp Rigshospitalet, Ctr Clin Intervent Res, Copenhagen Trial Unit, Copenhagen, Denmark
[8] Copenhagen Univ Hosp, Rigshospitalet, Neurosci Ctr, Dept Neuroanaesthesiol, Copenhagen, Denmark
[9] Univ Copenhagen, Hosp Bispebjerg, Dept Endocrinol, Copenhagen, Denmark
[10] Univ Copenhagen, Dept Nutr Exercise & Sports, Copenhagen, Denmark
[11] Novo Nord Fdn Ctr Basic Metab Res, Copenhagen, Denmark
关键词
beta-cell function; clinical trial; GLP-1; analogue; glycaemic control; incretin therapy; remission; type; 1; diabetes; BETA-CELL FUNCTION; GLUCAGON-LIKE PEPTIDE-1; ANTI-CD3; MONOCLONAL-ANTIBODY; GLYCEMIC CONTROL; ONSET; EFFICACY; SAFETY; REVERSAL; TIME;
D O I
10.1111/dom.15889
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aim: To test the effect of the glucagon-like peptide-1 receptor agonist, liraglutide, on residual beta-cell function in adults with newly diagnosed type 1 diabetes. Materials and Methods: In a multicentre, double-blind, parallel-group trial, adults with newly diagnosed type 1 diabetes and stimulated C-peptide of more than 0.2 nmol/L were randomized (1:1) to 1.8-mg liraglutide (Victoza) or placebo once daily for 52 weeks with 6 weeks of follow-up with only insulin treatment. The primary endpoint was the between-group difference in C-peptide area under the curve (AUC) following a liquid mixed-meal test after 52 weeks of treatment. Results: Sixty-eight individuals were randomized. After 52 weeks, the 4-hour AUC C-peptide response was maintained with liraglutide, but decreased with placebo (P = .002). Six weeks after end-of-treatment, C-peptide AUCs were similar for liraglutide and placebo. The average required total daily insulin dose decreased from 0.30 to 0.23 units/kg/day with liraglutide, but increased from 0.29 to 0.43 units/kg/day in the placebo group at week 52 (P < .001). Time without the need for insulin treatment was observed in 13 versus two patients and lasted for 22 weeks (from 3 to 52 weeks) versus 6 weeks (from 4 to 8 weeks) on average for liraglutide and placebo, respectively. Patients treated with liraglutide had fewer episodes of hypoglycaemia compared with placebo-treated patients. The adverse events with liraglutide were predominantly gastrointestinal and transient. Conclusions: Treatment with liraglutide improves residual beta-cell function and reduces the dose of insulin during the first year after diagnosis. Beta-cell function was similar at 6 weeks postliraglutide treatment.
引用
收藏
页码:4905 / 4915
页数:11
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