medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2018-4-36-41medsovet-2329Research ArticleСАХАРНЫЙ ДИАБЕТDIABETES MELLITUSЭффективность и безопасность дулаглутида – нового аналога ГПП-1 для введения один раз в неделюEfficacy and safety of dulaglutide: a novel once-weekly glucagon-like peptide-1 analogueПогореловаА. С.PogorelovaA. S.

Кандидат медицинских наук

PhD in medicine

ФадеевВ. В.FadeevV. V.

Член-корреспондент РАН, доктор медицинских наук, профессор

MD, Prof., Associate of RAS

Первый Московский государственный университет им. И.М. Сеченова Минздрава России (Сеченовский университет)РоссияSechenov First Moscow State Medical University of the Ministry of Health of RussiaRussian Federation201830032018043641Copyright © Погорелова А.С., Фадеев В.В., 20182018Погорелова А.С., Фадеев В.В.Pogorelova A.S., Fadeev V.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/2329

Агонисты рецепторов ГПП-1 – класс лекарственных средств с высокой эффективностью, хорошим профилем безопасности, рекомендованный в качестве препаратов второго выбора после метформина при лечении сахарного диабета 2-го типа. Дулаглутид – аналог ГПП-1, разработанный с помощью рекомбинантных технологий для подкожных инъекций один раз в неделю и одобренный для применения в качестве монотерапии и в комбинации с другими сахароснижающими средствами во многих странах. Результаты рандомизированных многоцентровых клинических исследований продемонстрировали преимущество монотерапии дулаглутидом в отношении гликемического контроля перед метформином у пациентов, ранее находящихся на диетотерапии, и не меньшую эффективность в сравнении с монотерапией лираглутидом при ежедневных инъекциях. При использовании в комбинации с другими сахароснижающими средствами (включая метформин, препараты сульфонилмочевины, метформин и пиоглитазон, метформин и прандиальный инсулин, инсулин гларгин) дулаглутид обладал не меньшей эффективностью, чем лираглутид 1,8 мг в день, и статистически более значимо снижал уровень гликированного гемоглобина, чем ситаглиптин, эксенатид для инъекций дважды в день и инсулин гларгин, в исследованиях продолжительностью 26–104 недели. При этом дулаглутид в дозе 1,5 мг/нед приводил к снижению веса, сохраняющемуся на протяжении двух лет терапии. Дулаглутид в целом хорошо переносился, а удобная одноразовая шприц-ручка для инъекций препарата один раз в неделю позволила существенно улучшить качество жизни пациентов и приверженность к лечению.

GLP-1 receptor agonists are a class of drugs with high efficacy, a good safety profile recommended as second-line drugs after metformin for the treatment of type 2 diabetes mellitus. Dulaglutide is a GLP-1 analogue designed for once weekly subcutaneous injection using recombinant technology and approved for use as monotherapy or in combination with other hypoglycemic agents in many countries. The randomized multicenter clinical trials have shown the advantage of dulaglutide monotherapy it had with respect to glycemic control over metformin in patients previously on diet therapy and no less efficacy compared with liraglutide monotherapy in daily injections. When used in combination with other hypoglycemic agents (including metformin, sulfonylurea preparations, metformin and pioglitazone, metformin and prandial insulin, insulin glargine), dulaglutide was no less effective than liraglutide at a dose of 1.8 mg per day and lowered the glycated hemoglobin level more significantly than sitagliptin, exenatide for injections twice a day and insulin glargine in the studies lasting 26–104 weeks. In this case, dulaglutide at a dose of 1.5 mg/week resulted in a weight loss lasting for two years of therapy. Dulaglutide was generally well tolerated, and a convenient disposable once-weekly self-injecting syringe-pen of the drug significantly improved the patient’s quality of life and encouraged adherence to therapy.

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The authors declare that there are no conflicts of interest present.