Background Glycemic control prevents onset and progression of diabetes-related long-term complications. The objective of this study was to demonstrate that twice daily insulin lispro low mix 25 is noninferior to twice...Background Glycemic control prevents onset and progression of diabetes-related long-term complications. The objective of this study was to demonstrate that twice daily insulin lispro low mix 25 is noninferior to twice daily human insulin mix 30/70 in achieving glycemic control as measured by hemoglobin Alc （HbAlc）, from baseline to endpoint, in patients with type 1 or 2 diabetes. Methods In this phase IV, crossover, open-label, multicenter study, 117 Chinese patients with diabetes were randomly assigned to one of two treatment sequence groups. One group received 12-week treatment with twice daily human insulin mix 30/70 followed by 12-week treatment with twice daily insulin lispro low mix 25, while the other group received the reverse treatment sequence. HbAlc, baseline-to-endpoint change in HbAlc, proportion of patients achieving target HbAlc ≤ 7% and 〈 6.5%, fasting blood glucose, and daily insulin doses were measured for each period. Safety and tolerability were also assessed. Results A statistically significant reduction （P≤0.0001） of HbAlc was achieved after each treatment （human insulin mix 30/70： mean HbA1c=7.91% （95% CI： 7,67%, 8.15%）; insulin lispro low mix 25： mean HbA1c=7.96% （95% CI： 7.72%, 8.20%））. The 95% Cl （-0.20, 0.10） of the difference between the two treatments satisfied the prespecified noninferiority margin of 0.3% （lower limit of 95% CI 〉 -0.3%）. No statistically significant differences between treatments were observed for any of the secondary efficacy measures. The incidence of treatment-emergent adverse events and hypoglycemia between the two treatments and treatment sequence groups was similar. Three serious adverse events were reported （human insulin mix 30/70 group： 2 patients （1.7%, hypoglycemic coma and cardiac failure）; insulin lispro low mix 25 group： 1 patient （0.9%, stroke））. All serious adverse events were resolved and no patients died during the study. Conclusion The results support noninferiority of twice daily insulin lispro low mix 25 versus twice daily human insulin mix 30/70 in HbAlc control in Chinese patients with type 1 or 2 diabetes.展开更多
Background Recombinant human parathyroid hormone （1-34） （rhPTH （1-34）） is the first agent in a unique class of anabolic therapies acting on the skeleton. The efficacy and safety of long-term administration of rh...Background Recombinant human parathyroid hormone （1-34） （rhPTH （1-34）） is the first agent in a unique class of anabolic therapies acting on the skeleton. The efficacy and safety of long-term administration of rhPTH （1-34） in Chinese postmenopausal women had not been evaluated. This study compared the clinical efficacy and safety of rhPTH （1-34） with elcatonin for treating postmenopausal women with osteoporosis in 11 urban areas of China. Methods A total of 453 postmenopausal women with osteoporosis were enrolled in an 18-month, multi-center, randomized, controlled study. They were randomized to receive either rhPTH （1-34） 20 μg （200 U） daily for 18 months, or elcatonin 20 U weekly for 12 months. Lumbar spine （L1-4） and femoral neck bone mineral density （BMD）, fracture rate, back pain as well as biochemical markers of bone turnover were measured. Adverse events were recorded. Results rhPTH （1-34） increased lumbar BMD significantly more than did elcatonin after 6, 12, and 18 months of treatment （4.3% vs. 1.9%, 6.8% vs. 2.7%, 9.5% vs. 2.9%, P 〈0.01）. There was only a small but significant increase of femoral neck BMD after 18 months （2.6%, P 〈0.01） in rhPTH groups. There were larger increases in bone turnover markers in the rhPTH （1-34） group than those in the elcatonin group after 6, 12, and 18 months （serum bone-specific alkaline phosphatase （BSAP） 93.7% vs. -3.6%; 117.8% vs. -4.1%; 49.2% vs. -5.8%, P 〈0.01; urinary C-telopeptide/creatinine （CTX/Cr） 250.0% vs. -29.5%; 330.0% vs. -41.4%, 273.0% vs. -10.6%, P 〈0.01）. rhPTH （1-34） showed similar effect of pain relief as elcatonin. The incidence of clinical fractures was 5.36% （6/112） in elcatonin group and 3.2% （11/341）in rhPTH （1-34）group （P=0.303）. Both treatments were well tolerated. Hypercaluria （9.4%） and hypercalcemia （7.0%） in rhPTH （1-34） group were transient and caused no clinical symptoms. Pruritus （8.2% vs. 2.7%, P=0.044） and redness of injection site （4.4% vs. 0,P=0.024） were more frequent in rhPTH （1-34）. Nausea/vomiting （16.1% vs. 6.2%, P=0.001） and hot flushes （7.1% vs. 0.6%, P 〈0.001） were more common in elcatonin group. Conclusions rhPTH （1-34） was associated with greater increases in lumbar spine BMD and bone formation markers. It could increase femoral BMD after 18 months of treatment, rhPTH could improve back pain effectively. The results of the present study indicate that rhPTH （1-34） is an effective, safe agent in treating Chinese postmenopausal women with osteoporosis. （ChiCTR- TRC-10000924）展开更多
Background Recombinant human parathyroid hormone （1-34） （rhPTH （1-34）） given by injection is a new seventh class drug of biological products, which is prepared by adopting gene recombination technique, rhPTH （1...Background Recombinant human parathyroid hormone （1-34） （rhPTH （1-34）） given by injection is a new seventh class drug of biological products, which is prepared by adopting gene recombination technique, rhPTH （1-34） is mainly used to treat osteoporosis, especially for postmenopausal women. This study compared the clinical efficacy and safety of rhPTH （1-34） with elcatonin for treating postmenopausal women with osteoporosis in 11 urban areas of China. Methods Two hundred and five women with osteoporosis were enrolled in a 6-month, multicenter, randomized, controlled study. They were randomized to receive either rhPTH （1-34） 20 ug （200 U） daily or elcatonin 20 U weekly. Lumbar spine （L1-4） and femoral neck bone mineral density （BMD）, as well as biochemical markers of bone turnover were measured. Adverse events were recorded. Results rhPTH （1-34） increased lumbar BMD significantly more than did elcatonin at 3 months and 6 months （2.38% vs 0.59%, P 〈0.05; 5.51% vs 1.55%, P 〈0.01）, but there were no significant increases of BMD in these two groups at femoral neck. There were larger mean increases in bone markers in the rhPTH （1-34） group than in the elcatonin group at 3 months and 6 months （serum bone-specific alkaline phosphatase （BSAP） 36.79% vs 0.31%; 92.42% vs -0.17%; urinary N-telopeptide/creatinine （NTX/Cr） 48.91% vs -5.32%; 68.82% vs -10.86%）. Both treatments were well tolerated and there were no significant differences detected between the two groups in the proportion of any adverse events and any serious adverse events （67.0% vs 59.0%; 0 vs 0）. Conclusions rhPTH （1-34） has more positive effects on bone formation, as shown by the larger increments of lumbar BMD and bone formation markers, than elcatonin, with only mild adverse events and no significant change in the liver, kidney or hematological indices.展开更多
文摘Background Glycemic control prevents onset and progression of diabetes-related long-term complications. The objective of this study was to demonstrate that twice daily insulin lispro low mix 25 is noninferior to twice daily human insulin mix 30/70 in achieving glycemic control as measured by hemoglobin Alc （HbAlc）, from baseline to endpoint, in patients with type 1 or 2 diabetes. Methods In this phase IV, crossover, open-label, multicenter study, 117 Chinese patients with diabetes were randomly assigned to one of two treatment sequence groups. One group received 12-week treatment with twice daily human insulin mix 30/70 followed by 12-week treatment with twice daily insulin lispro low mix 25, while the other group received the reverse treatment sequence. HbAlc, baseline-to-endpoint change in HbAlc, proportion of patients achieving target HbAlc ≤ 7% and 〈 6.5%, fasting blood glucose, and daily insulin doses were measured for each period. Safety and tolerability were also assessed. Results A statistically significant reduction （P≤0.0001） of HbAlc was achieved after each treatment （human insulin mix 30/70： mean HbA1c=7.91% （95% CI： 7,67%, 8.15%）; insulin lispro low mix 25： mean HbA1c=7.96% （95% CI： 7.72%, 8.20%））. The 95% Cl （-0.20, 0.10） of the difference between the two treatments satisfied the prespecified noninferiority margin of 0.3% （lower limit of 95% CI 〉 -0.3%）. No statistically significant differences between treatments were observed for any of the secondary efficacy measures. The incidence of treatment-emergent adverse events and hypoglycemia between the two treatments and treatment sequence groups was similar. Three serious adverse events were reported （human insulin mix 30/70 group： 2 patients （1.7%, hypoglycemic coma and cardiac failure）; insulin lispro low mix 25 group： 1 patient （0.9%, stroke））. All serious adverse events were resolved and no patients died during the study. Conclusion The results support noninferiority of twice daily insulin lispro low mix 25 versus twice daily human insulin mix 30/70 in HbAlc control in Chinese patients with type 1 or 2 diabetes.
文摘Background Recombinant human parathyroid hormone （1-34） （rhPTH （1-34）） is the first agent in a unique class of anabolic therapies acting on the skeleton. The efficacy and safety of long-term administration of rhPTH （1-34） in Chinese postmenopausal women had not been evaluated. This study compared the clinical efficacy and safety of rhPTH （1-34） with elcatonin for treating postmenopausal women with osteoporosis in 11 urban areas of China. Methods A total of 453 postmenopausal women with osteoporosis were enrolled in an 18-month, multi-center, randomized, controlled study. They were randomized to receive either rhPTH （1-34） 20 μg （200 U） daily for 18 months, or elcatonin 20 U weekly for 12 months. Lumbar spine （L1-4） and femoral neck bone mineral density （BMD）, fracture rate, back pain as well as biochemical markers of bone turnover were measured. Adverse events were recorded. Results rhPTH （1-34） increased lumbar BMD significantly more than did elcatonin after 6, 12, and 18 months of treatment （4.3% vs. 1.9%, 6.8% vs. 2.7%, 9.5% vs. 2.9%, P 〈0.01）. There was only a small but significant increase of femoral neck BMD after 18 months （2.6%, P 〈0.01） in rhPTH groups. There were larger increases in bone turnover markers in the rhPTH （1-34） group than those in the elcatonin group after 6, 12, and 18 months （serum bone-specific alkaline phosphatase （BSAP） 93.7% vs. -3.6%; 117.8% vs. -4.1%; 49.2% vs. -5.8%, P 〈0.01; urinary C-telopeptide/creatinine （CTX/Cr） 250.0% vs. -29.5%; 330.0% vs. -41.4%, 273.0% vs. -10.6%, P 〈0.01）. rhPTH （1-34） showed similar effect of pain relief as elcatonin. The incidence of clinical fractures was 5.36% （6/112） in elcatonin group and 3.2% （11/341）in rhPTH （1-34）group （P=0.303）. Both treatments were well tolerated. Hypercaluria （9.4%） and hypercalcemia （7.0%） in rhPTH （1-34） group were transient and caused no clinical symptoms. Pruritus （8.2% vs. 2.7%, P=0.044） and redness of injection site （4.4% vs. 0,P=0.024） were more frequent in rhPTH （1-34）. Nausea/vomiting （16.1% vs. 6.2%, P=0.001） and hot flushes （7.1% vs. 0.6%, P 〈0.001） were more common in elcatonin group. Conclusions rhPTH （1-34） was associated with greater increases in lumbar spine BMD and bone formation markers. It could increase femoral BMD after 18 months of treatment, rhPTH could improve back pain effectively. The results of the present study indicate that rhPTH （1-34） is an effective, safe agent in treating Chinese postmenopausal women with osteoporosis. （ChiCTR- TRC-10000924）
文摘Background Recombinant human parathyroid hormone （1-34） （rhPTH （1-34）） given by injection is a new seventh class drug of biological products, which is prepared by adopting gene recombination technique, rhPTH （1-34） is mainly used to treat osteoporosis, especially for postmenopausal women. This study compared the clinical efficacy and safety of rhPTH （1-34） with elcatonin for treating postmenopausal women with osteoporosis in 11 urban areas of China. Methods Two hundred and five women with osteoporosis were enrolled in a 6-month, multicenter, randomized, controlled study. They were randomized to receive either rhPTH （1-34） 20 ug （200 U） daily or elcatonin 20 U weekly. Lumbar spine （L1-4） and femoral neck bone mineral density （BMD）, as well as biochemical markers of bone turnover were measured. Adverse events were recorded. Results rhPTH （1-34） increased lumbar BMD significantly more than did elcatonin at 3 months and 6 months （2.38% vs 0.59%, P 〈0.05; 5.51% vs 1.55%, P 〈0.01）, but there were no significant increases of BMD in these two groups at femoral neck. There were larger mean increases in bone markers in the rhPTH （1-34） group than in the elcatonin group at 3 months and 6 months （serum bone-specific alkaline phosphatase （BSAP） 36.79% vs 0.31%; 92.42% vs -0.17%; urinary N-telopeptide/creatinine （NTX/Cr） 48.91% vs -5.32%; 68.82% vs -10.86%）. Both treatments were well tolerated and there were no significant differences detected between the two groups in the proportion of any adverse events and any serious adverse events （67.0% vs 59.0%; 0 vs 0）. Conclusions rhPTH （1-34） has more positive effects on bone formation, as shown by the larger increments of lumbar BMD and bone formation markers, than elcatonin, with only mild adverse events and no significant change in the liver, kidney or hematological indices.
