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Author: Medical team doctors report NMT NMT ENDO finishing compiler, please do not reprint without authorization.
Introduction: The 2021 American Endocrine Society (ENDO) annual meeting (ENDO) announced a number of research progress related to oral hypoglycemic drugs.
Yimaitong compiled and compiled some of the contents and shared with teachers.
Etogliflozin-In patients with T2DM combined with ASCVD and receiving insulin therapy, the efficacy and safety of Etogliflozin is good.
The VERTIS CV study evaluated the effect of SGLT-2i Ertugliflozin on type 2 diabetes ( The effect of T2DM) on the heart and kidney outcome of patients with atherosclerosis (ASCVD).
As a sub-study of the VERTIS CV study, this study aims to evaluate the efficacy and safety of Etogliflozin in patients with T2DM who have received insulin therapy but have not met the blood sugar target and combined with atherosclerotic cardiovascular disease (ASCVD).
A total of 1065 participants were included and randomly divided into three groups: placebo group, ERTU 5mg qd group, and ERTU 15mg qd group.
The primary endpoint of the study was the change in HbA1c from baseline at 18 weeks.
Secondary endpoints included the proportion of patients achieving HbA1c<7%, fasting blood glucose (FPG), body weight (BW), and systolic blood pressure (SBP) changes.
A total of 979 (91.
9%) patients completed the 18-week follow-up.
At week 18, compared with the placebo group, the HbA1c of the ERTU 5mg group and the ERTU 15mg group had a more significant reduction in HbA1c compared to the baseline (Figure 1).
The proportions of HbA1c<7% of the three groups of patients were 10.
7% (placebo), 20.
7% (ERTU 5mg) and 21.
1% (ERTU 15mg); ERTU (5mg and 15mg) treatment can significantly reduce FPG, BW, SBP, and 18 At the end of the week, the total insulin dose of patients in the ERTU 15mg treatment group decreased slightly.
Figure 1 Changes in HbA1c, fasting blood glucose, weight, and systolic blood pressure in the three groups of patients.
In terms of safety, among female patients, the incidence of reproductive system infections in the ERTU treatment group was significantly higher.
The incidence of urinary tract infection, symptomatic hypoglycemia and severe hypoglycemia was similar in the treatment group, and the incidence of hypovolemia was very low.
Conclusion Adding ERTU to insulin (± metformin) can significantly reduce HbA1c, FPG, BW and SBP in patients.
After 18 weeks of treatment, compared with the placebo group, the proportion of patients with T2DM and ASCVD in the ERTU treatment group with HbA1c<7.
0% was higher, and there was no increase in the risk of hypoglycemia.
SGLT-2i-In diabetic kidney transplant patients, the use of SGLT-2i can bring multiple benefits.
Researchers conducted a literature review to evaluate SGLT-2i in patients with T2DM after kidney transplantation or new development after transplantation.
Effectiveness and safety in patients with diabetes (NODAT).
The assessment results include blood pressure, blood sugar control, weight, renal function after transplantation, proteinuria, and adverse reactions.
The review included a total of 9 studies (including 4 case series studies, 3 cohort studies, 1 randomized controlled study, and 1 case report), including 144 diabetic kidney transplant recipients.
In all patients, eGFR>30mL/mim/1.
73m^2, HbA1c>6.
5%, and the SGLT-2i drugs used were empagliflozin (n=82), canagliflozin (n=34) and dapagliflozin ( n=28).Studies have found that the use of SGLT-2i in kidney transplant patients has the following benefits: ➤ slightly lower blood pressure; ➤ moderately improve blood sugar control (HbA1c) and reduce insulin resistance; ➤ moderate-significantly reduce the weight of the patient; ➤ make the kidney after transplantation The function remains stable; ➤Significantly reduce proteinuria.
In addition, the study also found that in kidney transplant patients, the most common adverse reaction of SGLT-2i was urinary tract infection (n=13), and there were no reports of normal blood glucose diabetic ketoacidosis or new ischemic lower limb amputation.
See Table 1 for details.
Table 1 Conclusion of the results of the study SGLT-2i has a good curative effect in diabetic kidney transplantation patients, and no obvious adverse reactions or complications occurred.
It is worth mentioning that the research team is also carrying out a prospective study of kidney transplant patients with T2DM or NODAT, eGFR ≥ 30mL/min/1.
73m^2, to further evaluate the use of SGLT-2i in this population Effectiveness and safety.
Metformin-or reduce the risk of dementia WHO estimates that by 2020, the number of people suffering from dementia in the world is about 50 million, and it is estimated that there will be about 10 million new cases each year, of which Alzheimer's disease (AD) is the most common dementia The form of the disease, accounting for more than 50% of all cases, type 2 diabetes (T2DM) has been proven to be the main risk factor for AD and dementia.
Even in the absence of clinical dementia, diabetes is associated with decreased cognitive ability and increased brain atrophy.
Compared with the general population, patients with T2DM have a 73% higher risk of dementia and a 56% higher risk of AD.
Metformin is the preferred hypoglycemic agent for T2DM.
A number of studies have shown that the use of metformin is associated with a reduction in the risk of dementia in T2DM.
At the same time, patients’ executive ability, learning, memory and concentration have been improved during treatment with metformin.
The protective mechanism may be that metformin can prevent hyperinsulinemia, the formation of amyloid β protein in the brain and the onset of AD.
Based on this, researchers have carried out a further exploration of the correlation between metformin and dementia in adult T2DM patients.
Researchers retrieved 61 relevant clinical research articles (2015-2020) on PubMed for analysis, and the results showed that compared with diabetic patients who did not take metformin, patients who took metformin had a lower risk of dementia or AD .
Because the relevant mechanism has not been ascertained, it is difficult for researchers to conduct clinical trials in AD patients.
The author believes that it may be effective to give metformin treatment before T2DM patients develop extensive amyloid and tau abnormal accumulation.
Introduction: The 2021 American Endocrine Society (ENDO) annual meeting (ENDO) announced a number of research progress related to oral hypoglycemic drugs.
Yimaitong compiled and compiled some of the contents and shared with teachers.
Etogliflozin-In patients with T2DM combined with ASCVD and receiving insulin therapy, the efficacy and safety of Etogliflozin is good.
The VERTIS CV study evaluated the effect of SGLT-2i Ertugliflozin on type 2 diabetes ( The effect of T2DM) on the heart and kidney outcome of patients with atherosclerosis (ASCVD).
As a sub-study of the VERTIS CV study, this study aims to evaluate the efficacy and safety of Etogliflozin in patients with T2DM who have received insulin therapy but have not met the blood sugar target and combined with atherosclerotic cardiovascular disease (ASCVD).
A total of 1065 participants were included and randomly divided into three groups: placebo group, ERTU 5mg qd group, and ERTU 15mg qd group.
The primary endpoint of the study was the change in HbA1c from baseline at 18 weeks.
Secondary endpoints included the proportion of patients achieving HbA1c<7%, fasting blood glucose (FPG), body weight (BW), and systolic blood pressure (SBP) changes.
A total of 979 (91.
9%) patients completed the 18-week follow-up.
At week 18, compared with the placebo group, the HbA1c of the ERTU 5mg group and the ERTU 15mg group had a more significant reduction in HbA1c compared to the baseline (Figure 1).
The proportions of HbA1c<7% of the three groups of patients were 10.
7% (placebo), 20.
7% (ERTU 5mg) and 21.
1% (ERTU 15mg); ERTU (5mg and 15mg) treatment can significantly reduce FPG, BW, SBP, and 18 At the end of the week, the total insulin dose of patients in the ERTU 15mg treatment group decreased slightly.
Figure 1 Changes in HbA1c, fasting blood glucose, weight, and systolic blood pressure in the three groups of patients.
In terms of safety, among female patients, the incidence of reproductive system infections in the ERTU treatment group was significantly higher.
The incidence of urinary tract infection, symptomatic hypoglycemia and severe hypoglycemia was similar in the treatment group, and the incidence of hypovolemia was very low.
Conclusion Adding ERTU to insulin (± metformin) can significantly reduce HbA1c, FPG, BW and SBP in patients.
After 18 weeks of treatment, compared with the placebo group, the proportion of patients with T2DM and ASCVD in the ERTU treatment group with HbA1c<7.
0% was higher, and there was no increase in the risk of hypoglycemia.
SGLT-2i-In diabetic kidney transplant patients, the use of SGLT-2i can bring multiple benefits.
Researchers conducted a literature review to evaluate SGLT-2i in patients with T2DM after kidney transplantation or new development after transplantation.
Effectiveness and safety in patients with diabetes (NODAT).
The assessment results include blood pressure, blood sugar control, weight, renal function after transplantation, proteinuria, and adverse reactions.
The review included a total of 9 studies (including 4 case series studies, 3 cohort studies, 1 randomized controlled study, and 1 case report), including 144 diabetic kidney transplant recipients.
In all patients, eGFR>30mL/mim/1.
73m^2, HbA1c>6.
5%, and the SGLT-2i drugs used were empagliflozin (n=82), canagliflozin (n=34) and dapagliflozin ( n=28).Studies have found that the use of SGLT-2i in kidney transplant patients has the following benefits: ➤ slightly lower blood pressure; ➤ moderately improve blood sugar control (HbA1c) and reduce insulin resistance; ➤ moderate-significantly reduce the weight of the patient; ➤ make the kidney after transplantation The function remains stable; ➤Significantly reduce proteinuria.
In addition, the study also found that in kidney transplant patients, the most common adverse reaction of SGLT-2i was urinary tract infection (n=13), and there were no reports of normal blood glucose diabetic ketoacidosis or new ischemic lower limb amputation.
See Table 1 for details.
Table 1 Conclusion of the results of the study SGLT-2i has a good curative effect in diabetic kidney transplantation patients, and no obvious adverse reactions or complications occurred.
It is worth mentioning that the research team is also carrying out a prospective study of kidney transplant patients with T2DM or NODAT, eGFR ≥ 30mL/min/1.
73m^2, to further evaluate the use of SGLT-2i in this population Effectiveness and safety.
Metformin-or reduce the risk of dementia WHO estimates that by 2020, the number of people suffering from dementia in the world is about 50 million, and it is estimated that there will be about 10 million new cases each year, of which Alzheimer's disease (AD) is the most common dementia The form of the disease, accounting for more than 50% of all cases, type 2 diabetes (T2DM) has been proven to be the main risk factor for AD and dementia.
Even in the absence of clinical dementia, diabetes is associated with decreased cognitive ability and increased brain atrophy.
Compared with the general population, patients with T2DM have a 73% higher risk of dementia and a 56% higher risk of AD.
Metformin is the preferred hypoglycemic agent for T2DM.
A number of studies have shown that the use of metformin is associated with a reduction in the risk of dementia in T2DM.
At the same time, patients’ executive ability, learning, memory and concentration have been improved during treatment with metformin.
The protective mechanism may be that metformin can prevent hyperinsulinemia, the formation of amyloid β protein in the brain and the onset of AD.
Based on this, researchers have carried out a further exploration of the correlation between metformin and dementia in adult T2DM patients.
Researchers retrieved 61 relevant clinical research articles (2015-2020) on PubMed for analysis, and the results showed that compared with diabetic patients who did not take metformin, patients who took metformin had a lower risk of dementia or AD .
Because the relevant mechanism has not been ascertained, it is difficult for researchers to conduct clinical trials in AD patients.
The author believes that it may be effective to give metformin treatment before T2DM patients develop extensive amyloid and tau abnormal accumulation.
