Clin Pharmacol Ther :2型糖尿病患者中GLP-1 RA和DPP-4抑制剂的使用与肠梗阻风险增加相关

2021-10-09 MedSci原创 MedSci原创

目前,我国上市的降糖药物种类约有10中,其中包括新型降糖药物二肽基肽酶-4(DPP-4)抑制剂,胰高血糖素样肽-1受体激动剂(GLP-1 RA)和钠-葡萄糖协同转运蛋白-2(SGLT-2)抑制剂等.

糖尿病治疗探索过程中,很多大型研究发现,强化降糖可长期控制血糖水平,降低患者大血管、微血管并发症和糖尿病相关终点事件的发生风险。目前,我国上市的降糖药物种类约有10中,其中包括新型降糖药物二肽基肽酶-4(DPP-4)抑制剂,胰高血糖素样肽-1受体激动剂(GLP-1 RA)和钠-葡萄糖协同转运蛋白-2(SGLT-2)抑制剂等

胰高血糖素样肽-1受体激动剂(GLP-1 RA)和二肽基肽酶-4(DPP-4)抑制剂可能增加肠梗阻的风险,但缺乏该重度不良事件的真实证据。因此,本研究的目的是确定与钠-葡萄糖协同转运蛋白-2(SGLT-2)抑制剂相比,GLP-1 RA和DPP-4抑制剂是否与肠梗阻风险增加相关。

实验方法

我们使用英国临床实践研究数据链和链接数据库组装两个新使用者、活性对照队列(2013-2019)。第一项研究分别包括25,617和67,261例GLP-1 RA和SGLT-2抑制剂使用者。第二项研究分别纳入了131,927例和40,615例DPP-4抑制剂和SGLT-2抑制剂使用者。拟合倾向评分精细分层加权Cox比例风险模型,估计需要住院的肠梗阻的风险比(HR)和95%置信区间(CI)。

实验结果

与SGLT-2抑制剂相比,GLP-1 RA与肠梗阻风险增加相关(分别为1.9 vs. 1.1/1000人年;HR:1.69,95%CI:1.04-2.74)。使用1.6年后观察到最高HR(HR:3.48,95%CI:1.79-6.79)。DPP-4抑制剂也与肠梗阻风险增加相关(2.7 vs. 1.0/1000人年;HR:2.59,95%CI:1.52-4.42),使用1.8年后观察到最高HR(HR:9.53,95%CI:4.47-20.30)。GLP-1 RA和DPP-4抑制剂使用1年后需要伤害的数量分别为1223和603。

结论

在这项大型现实世界研究中,GLP-1 RA和DPP-4抑制剂与肠梗阻风险增加相关。

 

原文链接:https://pubmed.ncbi.nlm.nih.gov/34587280/

Incretin-Based Drugs and Risk of Intestinal Obstruction Among Patients with Type 2 Diabetes.

2021 Sep 29. doi: 10.1002/cpt.2430. 

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    2022-07-15 jklm09
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[GetPortalCommentsPageByObjectIdResponse(id=1788448, encodeId=f4bb1e88448f1, content=<a href='/topic/show?id=38e014162e2' target=_blank style='color:#2F92EE;'>#Pharmacol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14162, encryptionId=38e014162e2, topicName=Pharmacol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=930e243, createdName=dingxiaobo, createdTime=Thu Sep 22 11:20:28 CST 2022, time=2022-09-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1787750, encodeId=62881e87750af, content=<a href='/topic/show?id=fa03141591e' target=_blank style='color:#2F92EE;'>#Pharm#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14159, encryptionId=fa03141591e, topicName=Pharm)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8942242, createdName=jj000001, createdTime=Fri Jan 21 19:20:28 CST 2022, time=2022-01-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1852770, encodeId=2f0b1852e70ae, content=<a href='/topic/show?id=f0a254918f0' target=_blank style='color:#2F92EE;'>#抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54918, encryptionId=f0a254918f0, topicName=抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Fri Jul 15 09:20:28 CST 2022, time=2022-07-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1996434, encodeId=f5d81996434f8, content=<a href='/topic/show?id=ed881120ec8' target=_blank style='color:#2F92EE;'>#MAC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11207, encryptionId=ed881120ec8, topicName=MAC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4b65161, createdName=yb6560, createdTime=Tue May 24 16:20:28 CST 2022, time=2022-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1908663, encodeId=1bc5190866399, content=<a href='/topic/show?id=a8d0141605e' target=_blank style='color:#2F92EE;'>#pharma#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14160, encryptionId=a8d0141605e, topicName=pharma)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f634250, createdName=chentianping, createdTime=Fri Dec 17 04:20:28 CST 2021, time=2021-12-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1784712, encodeId=33b91e84712c0, content=<a href='/topic/show?id=6a926214b8' target=_blank style='color:#2F92EE;'>#DPP-4抑制#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6214, encryptionId=6a926214b8, topicName=DPP-4抑制)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d139492, createdName=xue8602, createdTime=Tue Nov 30 17:20:28 CST 2021, time=2021-11-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1290111, encodeId=2a721290111a9, content=<a href='/topic/show?id=cea4815e119' target=_blank style='color:#2F92EE;'>#肠梗阻#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81571, encryptionId=cea4815e119, topicName=肠梗阻)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c950224, createdName=hjwang79, createdTime=Mon Oct 11 01:20:28 CST 2021, time=2021-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1374131, encodeId=477413e4131c9, content=<a href='/topic/show?id=dad4621545' target=_blank style='color:#2F92EE;'>#DPP-4抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6215, encryptionId=dad4621545, topicName=DPP-4抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a8d7373, createdName=ewsr1, createdTime=Mon Oct 11 01:20:28 CST 2021, time=2021-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1383721, encodeId=05d41383e2166, content=<a href='/topic/show?id=196a1101f7' target=_blank style='color:#2F92EE;'>#2型糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1101, encryptionId=196a1101f7, topicName=2型糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ec19483, createdName=aids213, createdTime=Mon Oct 11 01:20:28 CST 2021, time=2021-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1401968, encodeId=7e70140196829, content=<a href='/topic/show?id=7ff0621125' target=_blank style='color:#2F92EE;'>#DPP-4#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6211, encryptionId=7ff0621125, topicName=DPP-4)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJmFzSicR3biaepTGaMtOl8hS8SjNQ92YP4GmFUlefPkcPnZJWBsHM057ogFrQEPrgdTgPrlxG70KYA/132, createdBy=eeb42370314, createdName=gaoxiaoe, createdTime=Mon Oct 11 01:20:28 CST 2021, time=2021-10-11, status=1, ipAttribution=)]
    2022-05-24 yb6560
  5. [GetPortalCommentsPageByObjectIdResponse(id=1788448, encodeId=f4bb1e88448f1, content=<a href='/topic/show?id=38e014162e2' target=_blank style='color:#2F92EE;'>#Pharmacol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14162, encryptionId=38e014162e2, topicName=Pharmacol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=930e243, createdName=dingxiaobo, createdTime=Thu Sep 22 11:20:28 CST 2022, time=2022-09-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1787750, encodeId=62881e87750af, content=<a href='/topic/show?id=fa03141591e' target=_blank style='color:#2F92EE;'>#Pharm#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14159, encryptionId=fa03141591e, topicName=Pharm)], attachment=null, authenticateStatus=null, createdAvatar=, 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channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6214, encryptionId=6a926214b8, topicName=DPP-4抑制)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d139492, createdName=xue8602, createdTime=Tue Nov 30 17:20:28 CST 2021, time=2021-11-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1290111, encodeId=2a721290111a9, content=<a href='/topic/show?id=cea4815e119' target=_blank style='color:#2F92EE;'>#肠梗阻#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81571, encryptionId=cea4815e119, topicName=肠梗阻)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c950224, createdName=hjwang79, createdTime=Mon Oct 11 01:20:28 CST 2021, time=2021-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1374131, encodeId=477413e4131c9, content=<a 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1401968, encodeId=7e70140196829, content=<a href='/topic/show?id=7ff0621125' target=_blank style='color:#2F92EE;'>#DPP-4#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6211, encryptionId=7ff0621125, topicName=DPP-4)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJmFzSicR3biaepTGaMtOl8hS8SjNQ92YP4GmFUlefPkcPnZJWBsHM057ogFrQEPrgdTgPrlxG70KYA/132, createdBy=eeb42370314, createdName=gaoxiaoe, createdTime=Mon Oct 11 01:20:28 CST 2021, time=2021-10-11, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1788448, encodeId=f4bb1e88448f1, content=<a href='/topic/show?id=38e014162e2' target=_blank style='color:#2F92EE;'>#Pharmacol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14162, encryptionId=38e014162e2, topicName=Pharmacol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=930e243, createdName=dingxiaobo, createdTime=Thu Sep 22 11:20:28 CST 2022, time=2022-09-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1787750, encodeId=62881e87750af, content=<a href='/topic/show?id=fa03141591e' target=_blank style='color:#2F92EE;'>#Pharm#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14159, encryptionId=fa03141591e, topicName=Pharm)], attachment=null, authenticateStatus=null, createdAvatar=, 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1401968, encodeId=7e70140196829, content=<a href='/topic/show?id=7ff0621125' target=_blank style='color:#2F92EE;'>#DPP-4#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6211, encryptionId=7ff0621125, topicName=DPP-4)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJmFzSicR3biaepTGaMtOl8hS8SjNQ92YP4GmFUlefPkcPnZJWBsHM057ogFrQEPrgdTgPrlxG70KYA/132, createdBy=eeb42370314, createdName=gaoxiaoe, createdTime=Mon Oct 11 01:20:28 CST 2021, time=2021-10-11, status=1, ipAttribution=)]
  7. 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    2021-10-11 gaoxiaoe

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Clin Gastroenterol Hepatol:脂肪胰会大大增加糖尿病患病风险!

脂肪胰是后续发生糖尿病独立相关,但与高血压或血脂异常无关

Photodiagnosis Photodyn Ther:吲哚青绿介导的光动力疗法治疗糖尿病患者种植体周围炎的临床、细菌和炎症结果

近日,发表于Photodiagnosis Photodyn Ther的一项为期6个月的随机对照临床试验评估了吲哚青绿介导的光动力疗法(ICG-PDT)作为种植体周围人工清创术(PIMD)的辅助手段VS

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Diabetes Obes Metab:降糖药物的心血管疗效和安全性

与其他降糖药物相比,GLP-1 RAs、SGLT-2is和噻唑烷二酮类药物降低了MACE的风险。每一类药物都有其独特的优点和缺点。

Diabetes Obes Metab:2型糖尿病降糖药物预防心血管疾病的效果分析

来自随机试验的证据表明,不同的降糖药对2型糖尿病患者心血管发病率和死亡率有不同的影响。然而,ASCVD患者与无ASCVD和MRF患者之间降糖治疗疗效的区别似乎得到了现有证据的证实。

一文读懂:2型糖尿病合并心血管疾病日常该如何管理?

2型糖尿病合并心血管疾病的患者,除血糖管理外,日常应注重对心血管疾病危险因素的控制,主要包括降压、调脂和抗血小板治疗。

JCEM:新型间歇性禁食3个月,6年“老糖友”缓解持续12个月,药物费用降低77%!

Journal of Clinical Endocrinology & Metabolism:间歇性热量限制饮食对2型糖尿病缓解的影响:一项随机对照试验

注意!利尿剂与降糖药可能发生药物相互作用

临床医生需要了解与利尿剂相互作用的药物,以防止相关不良反应。

安进减肥新药AMG133放大招,直逼司美格鲁肽和Tirzepatide!

大家知道,在减重和降糖这个领域,最引领风骚的是Tirzepatide 和司美格鲁肽(也译为索马鲁肽),在业内几乎是王炸,一周一针,降糖减重,都十分显著!看看此前的报道: