OBJECTIVE To evaluate participant characteristics and long-term changes in glycated hemoglobin (HbA1c) levels in patients treated with dulaglutide 1.5 mg in a post hoc analysis of the Researching cardiovascular Events with a Weekly INcretin in Diabetes (REWIND) trial. RESEARCH DESIGN AND METHODS Change from baseline in HbA1c was assessed during and up to 72 months of treatment before and after adjustment for duration of diabetes, prior microvascular disease (nephropathy or retinopathy), and BMI. Slope analyses were used to assess the change in HbA1c during 0–12 months and 12–72 months of therapy. RESULTS HbA1c was significantly reduced in patients treated with dulaglutide compared with placebo during 72 months of treatment (least-squares mean difference = −0.61%, P < 0.001), regardless of diabetes duration, prior microvascular disease, and BMI (all interaction P > 0.07). Significant reductions were apparent at all time points and were independent of these baseline characteristics. Slope analyses revealed that the dulaglutide group experienced a higher rate of HbA1c reduction compared with the placebo group from 0 to 12 months before and after adjustment. The dulaglutide group also experienced a higher rate of HbA1c increase from 12 to 72 months compared with the placebo group that became nonsignificant after adjustment for diabetes duration, prior microvascular disease, and BMI combined. Despite the greater rate of HbA1c increase in the dulaglutide group during this period, mean HbA1c values remained below baseline in the dulaglutide group and below mean HbA1c values in the placebo group. CONCLUSIONS Dulaglutide 1.5-mg treatment was statistically associated with a long-lasting decrease in HbA1c over 72 months, irrespective of baseline duration of diabetes, microvascular disease, and BMI.

中文翻译：

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无论糖尿病、微血管疾病和 BMI 的持续时间如何，都拉鲁肽治疗患者的 HbA1c 降低：来自 REWIND 试验的事后分析

目的 评估接受度拉鲁肽 1.5 mg 治疗的患者的参与者特征和糖化血红蛋白 (HbA1c) 水平的长期变化，该研究对糖尿病每周胰岛素促泌素 (REWIND) 试验研究心血管事件进行了事后分析。研究设 斜率分析用于评估治疗 0-12 个月和 12-72 个月期间 HbA1c 的变化。结果 与安慰剂相比，在 72 个月的治疗期间，无论糖尿病病程、既往微血管疾病、和 BMI（所有交互作用 P > 0.07）。在所有时间点都有明显的减少，并且与这些基线特征无关。斜率分析显示，与安慰剂组相比，在调整前后 0 至 12 个月，度拉鲁肽组的 HbA1c 降低率更高。与安慰剂组相比，度拉鲁肽组从 12 个月到 72 个月的 HbA1c 增加率也更高，安慰剂组在调整糖尿病病程、既往微血管疾病和 BMI 后变得不显着。尽管在此期间度拉鲁肽组的 HbA1c 增加率更高，但度拉鲁肽组的平均 HbA1c 值仍低于基线，而安慰剂组的平均 HbA1c 值仍低于基线。结论 度拉鲁肽 1。