Effect of Anagliptin and Sitagliptin on Low-density Lipoprotein Cholesterol in Patients With Type 2 Diabetes and Cardiovascular Risk Factors: Randomized Controlled Trial
试验速览
- 阶段
- 4 期
- 状态
- 已完成
- 发起方
- 入组人数
- 353
- 试验地点
- 1
- 主要终点
- Change in glycated hemoglobin
研究概览
简要总结
The purpose of this study is to determine whether Anagliptin or Sitagliptin are effective in reducing the low-density lipoprotein cholesterol in patients with type 2 diabetes and cardiovascular risk factors on statin.
详细描述
Diabetes is a significant cause of cardiovascular and cerebrovascular events. Especially, diabetic patients with cardiovascular risk factors were significantly higher risk for cardiovascular and cerebrovasculara event. Therefore, several medical management strategies including anti-diabetic medications and statins were considered for those patients. However, in spite of such treatment, still many patients have cardiovascular and cerebrovascular events. One of the hypothesis is the residual risk such as elevated low-density lipoprotein cholesterol (LDLC) even with statin therapy. Anagliptin, one of the dipeptidyl peptidase-4 (DPP4) inhibiors, was reported to reduce LDLC and may have pontential to decrease the cardiovascular and cerebrovascular risk for such patients on statins. We, thus, conduct a randomized controlled trial to compare Anagliptin or Sitagliptin in terms of change of LDLC for 52 weeks as well as glycemic control.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Double (Investigator, Outcomes Assessor)
入排标准
- 年龄范围
- 20 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients with type 2 diabetes with cardiovascular risk factors (*) who treated with diet, exercise or antidiabetic medications
- •Patients who were treated with statins for 8 weeks or longer
- •Patients with low-density lipoprotein cholesterol equal to or greater than 100 mg/dL in the at least one of three measurements after the administration of statins
- •Patients with glycerated hemoglobin (HbA1c, NGSP) equal to or greater than 6.0 % (7.0 % if patients were not treated with dipeptidyl-peptidase 4 inhibitors) and lesser than 10.5 %
- •(*) cardiovascular risk factors were any of following conditions
- •Presence of stenosis (>=25%) or plaque on the previous coronary angiography or coronary CT
- •Presence of coronary calcification on the previous coronary CT
- •History of acute coronary syndrome
- •History of percutaneous coronary intervention or coronary artery bypass graft
- •History of stroke (ischemic stroke or hemorrhagic stroke)
- •History of transient ischemic attack
- •History of peripheral artery diseases or aortic disorders
- •Ankle-Brachial Index (AMI) equal to or less than 0.9 in the past measurement
- •Presence of carotid artery plaque (including Max IMT >=1.1mm) on carotid ultrasonography in the past
排除标准
- •Patients with type 1 diabetes
- •Patients with triglyceride equal to or greater than 400 mg/dL in the previous fasting measurements
- •Patients with pregnancy, possible pregnancy, or on breast-feeding
- •Patients with severe infections, perioperative status, or severe trauma
- •Patients with renal dysfunction (creatinine >= 2.4 mg/dl for men, >= 2.0 mg/dl for women)
- •Patients who were received glucagon-like peptide-1receptor agonists
- •Patients whom physician in charge considered inappropriate for the study
研究组 & 干预措施
Anagliptin
Anagliptin 100 mg bid for 52 weeks. Can increase to 200 mg bid if needed.
干预措施: Anagliptin (Drug)
Sitagliptin
Sitagliptin 50 mg qd for 52 weeks. Can increase to 100 mg qd if needed
干预措施: Sitagliptin (Drug)
结局指标
主要结局
Change in glycated hemoglobin
时间窗: 52-weeks
Change in low-density lipoprotein cholesterol
时间窗: 52-weeks
次要结局
- Change in fasting glucose(52-weeks)
- Change in C peptide(52-weeks)
- Change in total cholesterol, triglyceride, non high dencisty lipoprotein cholesterol(52-weeks)
- Change in Apolipoprotein A1, Apolipoprotein B, Apolipoprotein E(52-weeks)
- Change in fasting insulin(52-weeks)
- Change in cholesterol synthesis marker (lathosterol)(52-weeks)
- Change in high sensitivity C-reactive protein(52-weeks)
- Change in 1.5-Anhydro-D-glucitol(52-weeks)
- Change in Apolipoprotein B48(52-weeks)
- Change in small dense low density lipoprotein(52-weeks)
- Change in interleukin-6(52-weeks)
- Change in cholesterol absorption marker (campesterol; sitosterol)(52-weeks)
- Change in high molecular weight adiponectin(52-weeks)
- Change in ratio of albumin and creatinine in urine(52-weeks)
- Progression, unchange, remission rate of microalbumin and macroalbumin in urine(52-weeks)
- Change in estimated glomerular filtration rate(52-weeks)
- Change in glycated hemoglobin stratified by body mass index and waist circumference(52-weeks)
- Correlation between glycated hemoglobin and body mass index or waist circumference(52-weeks)
- Change in intima-media thickness or flow mediated dilation(52-weeks)
- Change in postprandial glucose, insulin and activated glucagon-like peptide-1(52-weeks)
- Change in lipid profile and molecular size measured(52-weeks)
- Change in fatty acid fraction(52-weeks)