Ipragliflozin improves glycemic control in Japanese patients with type 2 diabetes mellitus: the BRIGHTEN study: BRIGHTEN: double-blind randomized study of ipragliflozin to show its efficacy as monotherapy in T2DM patients

被引:75
作者
Kashiwagi A. [1 ]
Kazuta K. [2 ]
Takinami Y. [2 ]
Yoshida S. [2 ]
Utsuno A. [2 ]
Nagase I. [2 ]
机构
[1] Shiga University of Medical Science, Shiga
[2] Astellas Pharma Inc., 3-17-1 Hasune, Itabashi, Tokyo
关键词
Diabetes mellitus; Hypoglycemia; Ipragliflozin; Monotherapy; SGLT2;
D O I
10.1007/s13340-014-0164-0
中图分类号
学科分类号
摘要
Ipragliflozin is a sodium–glucose co-transporter 2 inhibitor under clinical development for treating type 2 diabetes mellitus (T2DM). In this Phase 3, multicenter, randomized, double-blind, placebo-controlled, parallel-group study, 129 Japanese patients with T2DM were randomized to either 50 mg ipragliflozin (n = 62) or placebo (n = 67) once daily for 16 weeks. Hemoglobin A1c (HbA1c) levels decreased significantly from baseline to the end of treatment in the ipragliflozin group (−0.76 %) but increased in the placebo group (+0.54 %), resulting in a placebo-adjusted mean change from baseline of −1.24 % (P < 0.001). Fasting plasma glucose (FPG) levels also decreased significantly in the ipragliflozin group (−40.2 mg/dL) but not in the placebo group (+6.3 mg/dL). The changes in body weight (−2.31 kg vs. −1.03 kg, P < 0.001) and waist circumference (−1.61 cm vs. −0.41 cm, P = 0.028) from baseline to the end of treatment were significantly greater in the ipragliflozin group than in the placebo group. Treatment-emergent adverse events occurred in 53.2 % and 59.7 % of patients in the ipragliflozin and placebo groups, respectively. All of the events were mild to moderate in severity. Hypoglycemia (ipragliflozin vs. placebo 1.6 % vs. 0 %), genital infections (3.2 % vs. 0 %), and urinary tract infection (0 % vs. 1.5 %) were rare. In conclusion, treatment with 50 mg ipragliflozin once daily for 16 weeks achieved significant improvements in HbA1c, FPG, body weight, and waist circumference compared with placebo in Japanese patients with T2DM. Ipragliflozin was well tolerated with low rates of genital infection and hypoglycemia. © 2014, The Japan Diabetes Society.
引用
收藏
页码:8 / 18
页数:10
相关论文
共 28 条
[1]  
World Health Organization. Diabetes, Fact Sheet 312, (2011)
[2]  
Tokyo: Ministry of Health, Labour, and Welfare, Japan, (2007)
[3]  
Neumiller J.J., White J.R., Campbell R.K., Sodium–glucose co-transport inhibitors: progress and therapeutic potential in type 2 diabetes mellitus, Drugs, 70, pp. 377-385, (2010)
[4]  
Kanai Y., Lee W.S., You G., Brown D., Hediger M.A., The human kidney low affinity Na<sup>+</sup>/glucose cotransporter SGLT2. Delineation of the major renal reabsorptive mechanism for d-glucose, J Clin Investig, 93, pp. 397-404, (1994)
[5]  
Tahara A., Kurosaki E., Yokono M., Yamajuku D., Kihara R., Hayashizaki Y., Takasu T., Imamura M., Qun L., Tomiyama H., Kobayashi Y., Noda A., Sasamata M., Shibasaki M., Pharmacological profile of ipragliflozin (ASP1941), a novel selective SGLT2 inhibitor, in vitro and in vivo, Naunyn Schmiedebergs Arch Pharmacol, 385, pp. 423-436, (2012)
[6]  
Kadokura T., Saito M., Utsuno A., Kazuta K., Yoshida S., Kawasaki S., Nagase I., Kageyama S., Ipragliflozin (ASP1941), a selective sodium-dependent glucose cotransporter 2 inhibitor, safely stimulates urinary glucose excretion without inducing hypoglycemia in healthy Japanese subjects, Diabetol Int, 2, pp. 172-182, (2011)
[7]  
Veltkamp S.A., Kadokura T., Krauwinkel W.J.J., Smulders R.A., Effect of ipragliflozin (ASP1941), a novel selective sodium-dependent glucose co-transporter 2 inhibitor, on urinary glucose excretion in healthy subjects, Clin Drug Investig, 31, pp. 839-851, (2011)
[8]  
Schwartz S.L., Akinlade B., Klasen S., Kowalski D., Zhang W., Wilpshaar W., Safety, pharmacokinetic, and pharmacodynamic profiles of ipragliflozin (ASP1941), a novel and selective inhibitor of sodium-dependent glucose co-transporter 2, in patients with type 2 diabetes mellitus, Diabetes Technol Ther, 13, pp. 1219-1227, (2011)
[9]  
Kashiwagi A., Kazuta K., Yoshida S., Nagase I., Randomized, placebo-controlled, double-blind glycemic control trial of novel sodium-dependent glucose cotransporter 2 inhibitor ipragliflozin in Japanese patients with type 2 diabetes mellitus, J Diabetes Investig, (2013)
[10]  
Fonseca V.A., Ferrannini E., Wilding J.P.H., Wilpshaar W., Dhanjal P., Ball G., Klasen S., Active- and placebo-controlled dose-finding study to assess the efficacy, safety, and tolerability of multiple doses of ipragliflozin in patients with type 2 diabetes mellitus, J Diabetes Complicat, 27, pp. 268-273, (2013)