1. Urinary glucose excretion after dapagliflozin treatment: An exposure-response modelling comparison between Japanese and non-Japanese patients diagnosed with type 1 diabetes mellitus.
- Author
-
Sokolov V, Yakovleva T, Ueda S, Parkinson J, Boulton DW, Penland RC, and Tang W
- Subjects
- Adolescent, Adult, Aged, Computer Simulation, Diabetes Mellitus, Type 1 metabolism, Dose-Response Relationship, Drug, Female, Humans, Japan, Male, Middle Aged, Randomized Controlled Trials as Topic, Renal Elimination, United States, Young Adult, Asian People, Benzhydryl Compounds administration & dosage, Blood Glucose metabolism, Diabetes Mellitus, Type 1 drug therapy, Glucosides administration & dosage, Glycosuria urine, Hypoglycemic Agents administration & dosage, Insulin administration & dosage, Sodium-Glucose Transporter 2 Inhibitors administration & dosage
- Abstract
Aims: To assess the dapagliflozin exposure-response relationship in Japanese and non-Japanese patients with type 1 diabetes mellitus (T1DM) and investigate if a dose adjustment is required in Japanese patients., Materials and Methods: Data from two clinical studies were used to develop a non-linear mixed effects model describing the relationship between dapagliflozin exposure (area under the concentration curve) and response (24-hour urinary glucose excretion [UGE]) in Japanese and non-Japanese patients with T1DM. The effects of patient-level characteristics (covariates; identified using a stepwise procedure) on response was also assessed. Simulations were performed using median-normalized covariate values., Results: Data from 84 patients were included. Average self-monitored blood glucose (SMBG) at day 7, change from baseline in total insulin dose at day 7, and baseline estimated glomerular filtration rate (eGFR) all had a significant effect on 24-hours UGE, with SMBG being the most influential. Dapagliflozin systemic exposure for matching doses and baseline eGFR was similar between Japanese and non-Japanese patients; however, higher SMBG and a greater reduction in total insulin dose was observed in the Japanese population. When the significant covariates were included, the model fit the data well for both populations, and accurately predicted exposure-response in the Japanese and non-Japanese populations, in agreement with the observed data., Conclusions: There was no difference in dapagliflozin exposure-response in Japanese and non-Japanese patients with T1DM once differences in renal function, glycaemic control and insulin dose reductions between studies were considered. Therefore, no dose adjustment is recommended in Japanese patients with T1DM., (© 2018 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.)
- Published
- 2019
- Full Text
- View/download PDF