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1.
Diabetes Obes Metab ; 17(2): 179-87, 2015 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-25406730

RESUMEN

AIMS: To investigate the efficacy and tolerability of albiglutide, a weekly glucagon-like peptide-1 receptor agonist, when added to metformin and glimepiride in a triple therapy regimen in people with type 2 diabetes mellitus. METHODS: This was a 156-week, randomized, double-blind, parallel-group, multicentre study. In the present paper we describe the primary results, namely those at 52 weeks. Adult participants (n = 685) were randomly assigned to albiglutide (30 mg/week), pioglitazone (30 mg/day) or placebo. If needed, blinded uptitration of albiglutide (to 50 mg/week) and pioglitazone (to 45 mg/day) was allowed. The participant's current dose of metformin (>1500 mg/day) was maintained throughout. The glimepiride dose (4 mg/day), standardized before randomization, could be decreased if persistent hypoglycaemia occurred. RESULTS: The week 52 model-adjusted difference in change of glycated haemoglobin (primary endpoint) for albiglutide versus placebo was -0.87 [95% confidence interval (CI) -1.07, -0.68]%-units (p < 0.001), and for albiglutide versus pioglitazone it was 0.25 (95% CI 0.10, 0.40)%-units; therefore, not non-inferior. In the albiglutide group only, fasting plasma glucose reduced rapidly in the first 2 weeks. Confirmed hypoglycaemia occurred in 14% of participants on albiglutide, 25% on pioglitazone and 14% on placebo. The mean (± standard error) weight change was -0.42 (±0.2) kg with albiglutide, +4.4 (±0.2) kg (p < 0.001) with pioglitazone, and -0.40 (±0.4) kg with placebo and serious adverse events occurred in 6.3, 9.0 and 6.1% of participants in the respective groups. Injection site reactions occurred in 13% of participants on albiglutide and resulted in treatment discontinuation for four participants (1.4%). CONCLUSIONS: Albiglutide, as part of triple therapy, provided effective glucose-lowering and was generally well tolerated.


Asunto(s)
Diabetes Mellitus Tipo 2/tratamiento farmacológico , Péptido 1 Similar al Glucagón/análogos & derivados , Hemoglobina Glucada/efectos de los fármacos , Hipoglucemiantes/uso terapéutico , Tiazolidinedionas/uso terapéutico , Glucemia/efectos de los fármacos , Diabetes Mellitus Tipo 2/sangre , Inhibidores de la Dipeptidil-Peptidasa IV/uso terapéutico , Método Doble Ciego , Esquema de Medicación , Quimioterapia Combinada , Femenino , Péptido 1 Similar al Glucagón/administración & dosificación , Péptido 1 Similar al Glucagón/efectos adversos , Péptido 1 Similar al Glucagón/uso terapéutico , Humanos , Hipoglucemiantes/administración & dosificación , Hipoglucemiantes/efectos adversos , Masculino , Metformina/uso terapéutico , Persona de Mediana Edad , Pioglitazona , Compuestos de Sulfonilurea/uso terapéutico , Tiazolidinedionas/administración & dosificación , Tiazolidinedionas/efectos adversos , Resultado del Tratamiento
2.
Indian J Med Microbiol ; 30(1): 93-5, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-22361769

RESUMEN

Carbapenem resistance among clinical isolates of Enterobacteriaceae, especially Escherichia coli and Klebsiella pneumoniae, is largely conferred by metallo-ß-lactamase (MBL). Fifty-one non repetitive isolates of carbapenem-resistant (Meropenem and Imipenem) E. coli and K. pneumoniae were studied to determine the molecular mechanism for resistance. Presence of blaNDM and blaVIM was determined by polymerase chain reaction (PCR) and DNA sequencing. blaNDM was detected from majority of carbapenem-resistant K. pneumoniae (75%) and E. coli (66.6%). Timely detection and appropriate and aggressive infection control measures are required to control the spread of these bacteria in healthcare settings.


Asunto(s)
Antibacterianos/farmacología , Carbapenémicos/farmacología , Infecciones por Escherichia coli/microbiología , Escherichia coli/efectos de los fármacos , Infecciones por Klebsiella/microbiología , Klebsiella pneumoniae/efectos de los fármacos , Resistencia betalactámica , ADN Bacteriano/genética , Escherichia coli/enzimología , Escherichia coli/genética , Escherichia coli/aislamiento & purificación , Hospitales , Humanos , India , Klebsiella pneumoniae/enzimología , Klebsiella pneumoniae/genética , Klebsiella pneumoniae/aislamiento & purificación , Reacción en Cadena de la Polimerasa , Análisis de Secuencia de ADN , beta-Lactamasas/genética
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