Pharmacoeconomic analysis (CER) of Dulaglutide and Liraglutide in the treatment of patients with type 2 diabetes

AimTo evaluate the treatment effect Fand pharmacoeconomic value of Dugaglutide in women with type 2 diabetes.MethodsWomen (n=96) with type 2 diabetes recruited from June 2019 to December 2021 were randomized into two equal groups. The control group was treated with Liraglutide, and the observation group was treated with Dulaglutide, both for 24 weeks. The blood glucose levels, biochemical index, insulin resistance index (HOMA-IR), cost-effect ratio (CER), and drug safety were determined and compared between the two groups.ResultsBlood glucose levels, the biochemical index, and HOMA-IR were lower in both groups after the treatment (P < 0.05), and there was no statistical difference in the blood glucose levels, biochemical index and HOMA-IR between the two groups (P > 0.05). The CER levels did not differ statistically between the two groups (P > 0.05). Both the cost and the incidence of drug side effects during solution injection were lower in the observation group than in the control group after 24 weeks of treatment (P < 0.05).ConclusionBoth Dulaglutide and Liraglutide can reduce blood glucose levels, improve biochemical index, and HOMA-IR levels in women with type 2 diabetes. Dulaglutide is more cost-effective and safe.Clinical trial registrationhttps://www.chictr.org.cn/index.aspx, identifier ChiCTR1900026514

Efficacy of polyethylene glycol loxenatide versus insulin glargine on glycemic control in patients with type 2 diabetes: a randomized, open-label, parallel-group trial

Objective: This trial aimed to evaluate the glycemic control of polyethylene glycol loxenatide measured with continuous glucose monitoring (CGM) in patients with type 2 diabetes mellitus (T2DM), with the hypothesis that participants given PEG-Loxe would spend more time in time-in-range (TIR) than participants were given insulin glargine after 24 weeks of treatment.Methods: This 24-week, randomized, open-label, parallel-group study was conducted in the Department of Endocrine and Metabolic Diseases, Longhu Hospital, Shantou, China. Participants with T2DM, who were ≥45 years of age, HbA1c of 7.0%–11.0%, and treated at least 3 months with metformin were randomized (1:1) to receive PEG-Loxe or insulin glargine. The primary endpoint was TIR (blood glucose range: 3.9–10.0 mmol/L) during the last 2 weeks of treatment (weeks 22–24).Results: From March 2020 to April 2022, a total of 107 participants with T2DM were screened, of whom 78 were enrolled into the trial (n = 39 per group). At the end of treatment (weeks 22–24), participants given PEG-Loxe had a greater proportion of time in TIR compared with participants given insulin glargine [estimated treatment difference (ETD) of 13.4% (95% CI, 6.8 to 20.0, p < 0.001)]. The tight TIR (3.9–7.8 mmol/L) was greater with PEG-Loxe versus insulin glargine, with an ETD of 15.6% (95% CI, 8.9 to 22.4, p < 0.001). The time above range (TAR) was significantly lower with PEG-Loxe versus insulin glargine [ETD for level 1: −10.5% (95% CI: −14.9 to −6.0), p < 0.001; ETD for level 2: −4.7% (95% CI: −7.9 to −1.5), p = 0.004]. The time below range (TBR) was similar between the two groups. The mean glucose was lower with PEG-Loxe versus insulin glargine, with an ETD of −1.2 mmol/L (95% CI, −1.9 to −0.5, p = 0.001). The SD of CGM glucose levels was 1.88 mmol/L for PEG-Loxe and 2.22 mmol/L for insulin glargine [ETD -0.34 mmol/L (95% CI: −0.55 to −0.12), p = 0.002], with a similar CV between the two groups.Conclusion: The addition of once-weekly GLP-1RA PEG-Loxe to metformin was superior to insulin glargine in improving glycemic control and glycemic variability evaluated by CGM in middle-aged and elderly patients with T2DM

Study on the Role of Salicylic Acid in Watermelon-Resistant Fusarium Wilt under Different Growth Conditions

Background: Fusarium wilt disease is leading threat to watermelon yield and quality. Different cultivation cropping systems have been reported as safe and efficient methods to control watermelon Fusarium wilt. However, the role of salicylic acid (SA) in watermelon resistance to Fusarium wilt in these different cultivation systems remains unknown. Methods: in this experiment, we used RNA-seq and qRT-PCR to study the effect of SA biosynthesis on improving watermelon health, demonstrating how it may be responsible for Fusarium wilt resistance under continuous monocropping and oilseed rape rotation systems. Results: the results revealed that the expression of the CIPALs genes was key to SA accumulation in watermelon roots. We observed that the NPR family genes may play different roles in responding to the SA signal. Differentially expressed NPRs and WRKYs may interact with other phytohormones, leading to the amelioration of watermelon Fusarium wilt. Conclusions: further understanding of gene expression patterns will pave the way for interventions that effectively control the disease

Study on the Role of Phytohormones in Resistance to Watermelon Fusarium Wilt

Fusarium wilt disease is one of the major diseases causing a decline in watermelon yield and quality. Researches have informed that phytohormones play essential roles in regulating plants growth, development, and stress defendants. However, the molecular mechanism of salicylic acid (SA), jasmonic acid (JA), and abscisic acid (ABA) in resistance to watermelon Fusarium wilt remains unknown. In this experiment, we established the SA, JA, and ABA determination system in watermelon roots, and analyzed their roles in against watermelon Fusarium wilt compared to the resistant and susceptible varieties using transcriptome sequencing and RT-qPCR. Our results revealed that the up-regulated expression of Cla97C09G174770, Cla97C05G089520, Cla97C05G081210, Cla97C04G071000, and Cla97C10G198890 genes in resistant variety were key factors against (Fusarium oxysporum f. sp. Niveum) FON infection at 7 dpi. Additionally, there might be crosstalk between SA, JA, and ABA, caused by those differentially expressed (non-pathogen-related) NPRs, (Jasmonate-resistant) JAR, and (Pyrabactin resistance 1-like) PYLs genes, to trigger the plant immune system against FON infection. Overall, our results provide a theoretical basis for watermelon resistance breeding, in which phytohormones participate

Study on the Role of Phytohormones in Resistance to Watermelon <i>Fusarium</i> Wilt

Fusarium wilt disease is one of the major diseases causing a decline in watermelon yield and quality. Researches have informed that phytohormones play essential roles in regulating plants growth, development, and stress defendants. However, the molecular mechanism of salicylic acid (SA), jasmonic acid (JA), and abscisic acid (ABA) in resistance to watermelon Fusarium wilt remains unknown. In this experiment, we established the SA, JA, and ABA determination system in watermelon roots, and analyzed their roles in against watermelon Fusarium wilt compared to the resistant and susceptible varieties using transcriptome sequencing and RT-qPCR. Our results revealed that the up-regulated expression of Cla97C09G174770, Cla97C05G089520, Cla97C05G081210, Cla97C04G071000, and Cla97C10G198890 genes in resistant variety were key factors against (Fusarium oxysporum f. sp. Niveum) FON infection at 7 dpi. Additionally, there might be crosstalk between SA, JA, and ABA, caused by those differentially expressed (non-pathogen-related) NPRs, (Jasmonate-resistant) JAR, and (Pyrabactin resistance 1-like) PYLs genes, to trigger the plant immune system against FON infection. Overall, our results provide a theoretical basis for watermelon resistance breeding, in which phytohormones participate

Real-world effectiveness of GLP-1 receptor agonist-based treatment strategies on “time in range” in patients with type 2 diabetes

Background: Diabetes affects millions of people worldwide annually, and several methods, including medications, are used for its management; glucagon-like peptide-1 receptor agonists (GLP-1RAs) are one such class of medications. The efficacy and safety of GLP-1RAs in treating type 2 diabetes mellitus (T2DM) have been assessed and have been shown to significantly improve time in range (TIR) in several clinical trials. However, presently, there is a lack of real-world evidence on the efficacy of GLP-1RAs in improving TIR. To address this, we investigated the effect of GLP-1RA-based treatment strategies on TIR among patients with T2DM in real-world clinical practice.Methods: This multicenter, retrospective, real-world study included patients with T2DM who had previously used a continuous glucose monitoring (CGM) system and received treatment with GLP-1RAs or oral antidiabetic drugs (OADs). Patients who received OADs served as controls and were matched in a 1:1 ratio to their GLP-1RA counterparts by propensity score matching. The primary endpoint was the TIR after 3–6 months of treatment.Results: According to propensity score matching, 202 patients were equally divided between the GLP-1RA and OAD groups. After 3–6 months of treatment, the TIR values for the GLP-1RA and OAD groups were 76.0% and 65.7%, respectively (p &lt; 0.001). The GLP-1RA group displayed significantly lower time above range (TAR) and mean glucose values than the OAD group (p &lt; 0.001). Subgroup analysis revealed that, compared with the administration of liraglutide, the administration of semaglutide and polyethylene glycol loxenatide (PEG-Loxe) significantly improved TIR over 3–6 months of treatment (p &lt; 0.05).Conclusion: These real-world findings indicate that GLP-1RA-based treatment strategies could be superior to oral treatment strategies for improving TIR among patients with T2DM and that once-weekly GLP-1RA may be more effective than a once-daily GLP-1RA.Clinical trial registration:http://www.chinadrugtrials.org.cn/index.html, identifier number ChiCTR2300073697

Study on the Role of Salicylic Acid in Watermelon-Resistant Fusarium Wilt under Different Growth Conditions

Background: Fusarium wilt disease is leading threat to watermelon yield and quality. Different cultivation cropping systems have been reported as safe and efficient methods to control watermelon Fusarium wilt. However, the role of salicylic acid (SA) in watermelon resistance to Fusarium wilt in these different cultivation systems remains unknown. Methods: in this experiment, we used RNA-seq and qRT-PCR to study the effect of SA biosynthesis on improving watermelon health, demonstrating how it may be responsible for Fusarium wilt resistance under continuous monocropping and oilseed rape rotation systems. Results: the results revealed that the expression of the CIPALs genes was key to SA accumulation in watermelon roots. We observed that the NPR family genes may play different roles in responding to the SA signal. Differentially expressed NPRs and WRKYs may interact with other phytohormones, leading to the amelioration of watermelon Fusarium wilt. Conclusions: further understanding of gene expression patterns will pave the way for interventions that effectively control the disease