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薬理と治療
- Author: 加来 浩平1
Abstract
Background For the prevention of complications, the Japan Diabetes Society(JDS)recommended an HbA1c level of less than 7.0% as the goal for glycemic control. We assessed the achievement rates of less than 7.0% HbA1c in Japanese type 2 diabetic patients treated with anagliptin. Methods We calculated the goal achievement rates for glycemic control in phaseⅡ, phase Ⅱ/Ⅲ and phaseⅢ trial. A pooled analysis was also performed on phaseⅡ and Ⅲ due to their similar trial design. The goal achievement rates of less than 7.0% HbA1c, fasting plasma glucose of less than 130 mg/dL, plasma glucose levels 2-hr after the load of less than 180 mg/dL as recommended by the Japan Diabetes Society were calculated at 12 weeks and 52 weeks. Results At 12 weeks, goal achievement rates of less than 7.0% HbA1c were over the 50% in the group treated with anagliptin 100 mg BID. Also, the treatment with anagliptin 100 mg BID showed significantly higher achievement rates relative to voglibose treatment. The goal achievement rates of less than 7.0% HbA1c in combination therapy with anagliptin at 12 weeks were 40.3%, 39.4%, 30.0% and 34.8% in α-glucosidase inhibitor, thiazolidine, sulfonylurea, or biguanide treated patients, respectively. In each of these cases, combination therapy group showed significantly higher goal achievement rates relative to the group of placebo. (α-glucosidase inhibitor combination group P<0.01, thiazolidine combination group P<0.01, sulfonylurea combination group P<0.001, biguanide group P<0.001)Conclusions Monotherapy and combination therapy with anagliptin significantly improved the achievement rates of the goal for glycemic control in Japanese patients with type 2 diabetes.
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