Q: What about compliance with Glucobay??- how can you make sure patients will follow the minimum of four-years therapy stretch in ACE?
Q: 请问拜唐苹的依从性如何？ACE研究将最少随访4年，如何保证受试者能圆满地完成随访？
A: Acarbose， the active ingredient in Glucobay??， delays the hydrolysis of carbohydrates in the upper small intestine， so that undigested carbohydrate reaches the lower small intestine， and even the colon， in the early treatment phase. Within 2-3 weeks the body adjusts to acarbose use with increased enzyme activity in the lower small intestine- a process that also naturally occurs with a high fiber diet. Therefore， it is important that Glucobay therapy is initiated with a slow starting dose and stepwise titration to higher doses-a regimen known as the°∞start low， go slow°± principle. This principle will be followed in the ACE study when patients are started on treatment with acarbose-as well as with matching placebo. (Dosage up to 50mg will be administered three times daily with tablets taken at mealtimes to ensure compliance and to minimize patient drop-out.)
Chinese physicians are very experienced and knowledgeable about the use of Glucobay??， maximizing the chance of patient compliance over the study period.
A: 阿卡波糖在治疗早期可延迟碳水化合物在近端小肠的水解吸收，从而使未消化的碳水化合物到达远端小肠甚至结肠，在2~3周后机体已经适应了阿卡波糖，远端小肠中酶活性增加，这一过程在高纤维饮食时也可发生。因此，在拜唐苹给药策略方面，应该从小剂量起始并逐步增加至大剂量，这是非常重要的。在ACE研究中，患者开始使用阿卡波糖治疗时遵照“小剂量开始，缓慢增加”这一原则，与之匹配的安慰剂也是如此。（拜唐苹最大剂量为50 mg，每天用药三次，餐时服用以保证患者的依从性，尽可能减少中止治疗的患者。）
而且，中国医生对拜唐苹的使用非常有经验，这有助于最大限度地保证患者在研究期间的依从性。