薬理と治療

Volume 42, Issue 9, 2014
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扉・目次
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OPINION
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INFORMATION
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ORIGINAL ARTICLES
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DPP—4 阻害剤Anagliptin は日本人2 型糖尿病患者のHbA1c を肥満の有無にかかわらず低下させる
42巻9号(2014);View Description
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Background A recent meta︱analysis indicated that the baseline body mass index (BMI)was correlated with the efficacy of dipeptidyl peptidase-4(DPP-4)inhibitors for lowering HbA1c levels. We assessed whether the HbA1c︱lowering effect of anagliptin was influenced by the presence of obesity in Japanese patients with type 2 diabetes. Methods This study incorporated data from phase Ⅱ and phase Ⅱ╱Ⅲ trials, and mean changes in HbA1c levels from baseline to 12 weeks after the administration of anagliptin were analyzed by the baseline BMI and HOMA-IR. In addition, we analyzed the HbA1c-lowering effects of anagliptin at 52 weeks by the baseline BMI in phase Ⅲ trial. Additionally, we investigated factors that influenced the efficacy of anagliptin for lowering HbA1c levels. Results After 12 weeks of anagliptin treatment, the mean changes in HbA1c levels did not differ significantly between the groups with baseline BMI<25 kg╱m2 and BMI≳25 kg╱m2(-0.74% vs. -0.71%, respectively;P=0.662). Moreover, mean changes in HbA1c levels at 12 weeks were not correlated with the baseline HOMA︱IR values(r=-0.086, P=0.207). At 52 weeks, the HbA1c︱lowering efficacy of anagliptin in the 2 groups with baseline BMI<25 kg╱m2 and BMI≳25 kg╱m2 was not different(-0.70% vs. -0.54%, respectively;P=0.238).Weight gain from 24 weeks to 52 weeks was significantly related to poor glycemic control at long-term monotherapy with anagliptin. Conclusions The HbA1c-lowering efficacy of anagliptin monotherapy was not influenced by the presence of obesity. -
関節リウマチ患者に対するイグラチモドの有用性に関する観察研究
42巻9号(2014);View Description
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Objectives Previous clinical studies have demonstrated that iguratimod(IGU) monotherapy and concomitant IGU therapy with methotrexate are effective in patients with rheumatoid arthritis(RA). However, the clinical profile of this drug has not been sufficiently clarified yet. We investigated the efficacy and safety of IGU in RA patients treated in our hospital. Patients and Methods Seventeen RA patients(12 females)who received IGU were observed in this retrospective study. The mean age of the patients was 69±11(SD)years, and the mean duration of disease was 8.7±11.5 years. As concomitant treatment, nine patients received methotrexate(8.4±3.3 mg╱week), six patients were given biologics, and 14 patients used glucocorticoids(prednisolone equivalent dose:5.8±2.4 mg╱day). The disease activity score(DAS)28︱ erythrocyte sedimentation rate(ESR)was monitored until 24 weeks after the start of IGU therapy. Results In week 24, 10╱17 patients(58.8%)remained on IGU therapy and 7 patients had discontinued it.Three patients discontinued IGU due to side effects(gastrointestinal symptoms),three patients discontinued due to lack of efficacy, and one patient discontinued due to difficulty in attending hospital. When the 17 patients were divided into two groups with an RA duration of six years or more versus less than six years, a trend of greater efficacy was observed in the latter group and there was little change of DAS28︱ESR in the former group. The incidence of adverse reactions and abnormal laboratory test results was 58.8% and 41.2%, respectively. Conclusion IGU therapy improved disease activity in RA patients with a relatively short duration of disease. -
高架橋澱粉の摂取が便秘傾向の成人女性の排便に及ぼす影響
42巻9号(2014);View Description
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Objectives We investigated the efficacy and dose-dependent effect of highly cross-linked starch(HXLS)from tapioca on defecation. Methods Fifty four healthy female subjects with constipation tendency were recruited for a randomized and placebo-controlled study. After 2-week observation period(Pre-Period), all subjects received 28 g of placebo biscuits(without HXLS)for 2 weeks(PeriodⅠ). Following PeriodⅠ, subjects received placebo, low︱dose(3.5 g of dietary fiber from HXLS), or high-dose(7 g of dietary fiber from HXLS)biscuits for 2 weeks (PeriodⅡ). During 6-week test period, subjects were requested to record symptoms such as stool frequency, stool volume. Results Compared to Pre-Period, no significant effect was observed in low-dose group, whereas high-dose group showed significantly higher frequency of defecation during PeriodⅡ. Conclusion The investigation revealed that defecation frequency depends on dietary fiber intake and effective amount of dietary fiber from HXLS is 7 g. -
難消化性デキストリン配合炭酸飲料の食後中性脂肪値上昇抑制効果の検討―プラセボ対照ランダム化二重盲検クロスオーバー比較試験―
42巻9号(2014);View Description
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Objectives To evaluate the effect of the carbonated beverage containing resistant maltodextrin on the postprandial serum triglyceride levels. Trial design Randomized double-blinded placebo-controlling crossover study Methods For evaluation of the effect on postprandial serum triglyceride levels, a double-blinded crossover study was performed. Ninety volunteers were randomly divided into two groups and ingested a fat-rich diet together with 1 bottle(350mL)of the beverage that either did or did not contain resistant maltodextrin. Serum triglyceride levels were measured before and 2, 3, 4, and 6 hours after ingestion. Results Intake of the carbonated beverage containing resistant maltodextrin significantly suppressed the elevation of postprandial serum triglyceride levels at 2 and 3 hours after ingestion compared to levels with intake of placebo beverage(P<0.05). Conclusion These results indicated that the carbonated beverage containing resistant maltodextrin taken with a meal had an inhibitory effect on the postprandial serum triglyceride elevation. -
難消化性デキストリン配合炭酸飲料の長期摂取,過剰摂取における安全性の検討―プラセボ対照ランダム化二重盲検並行群間比較試験―
42巻9号(2014);View Description
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Objectives To evaluate the safety of long︱term intake and excessive intake of the carbonated beverage containing resistant maltodextrin. Trial design Randomized double-blinded placebo-controlling parallel-group comparison study Methods For the safety evaluations of long︱term intake and excessive intake of the carbonated beverage, double︱blinded parallel group studies were performed respectively. Forty volunteers were randomly divided into two groups for each study, and took daily 1 bottle(350mL)of the carbonated beverage that either did or did not contain resistant maltodextrin for 12 weeks (long-term intake)or 3 bottles of each beverage daily for 4 weeks(excessive intake). Results In the long-term and excessive intake trials, no abnormal changes triggered by ingestion of the test beverage were observed in clinical findings such as laboratory blood test, urinalysis and physical examination. Conclusion These results indicated that the carbonated beverage containing resistant maltodextrin were safe for long-term and excessive intake. -
健常成人における大麦β—グルカン1 g 含有クラッカーの食後血糖応答に及ぼす影響―無作為化二重盲検プラセボ対照クロスオーバー比較試験―
42巻9号(2014);View Description
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Objectives The aim of the present study was to investigate the effect of barley crackers containing 1 gram of β︱glucan on postprandial glucose response. Methods The study was a randomized, double︱blind, placebo︱controlled, crossover study with twenty︱two healthy adults whose fasting blood glucose was normal level. Subjects consumed test meals of each of the two crackers with banana yogurt, containing the same amount (50g)of available carbohydrates at breakfast on separate occasions. Blood glucose and insulin were measured up to 120 min after the breakfast. Results Barley crackers containing 1 gram of β-glucan lowered the blood glucose incremental areas under the curve(IAUC)(0-60 min)compared with placebo crackers at breakfast(P<0.05). The blood insulin was not changed after ingestion of the test meals at breakfast. Conclusions These findings suggested that barley crackers containing 1 gram of β-glucan contributed to postprandial glucose response. The present study suggested that it has potential to an advantage for glucose metabolism in healthy adults.
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