JAMA Intern Med:SGLT-2抑制剂 vs磺脲类药物对II型糖尿病患者死亡风险的影响

2021-07-06 MedSci原创 MedSci原创

与磺脲类药物相比,使用二甲双胍-SGLT-2抑制剂联合治疗可降低II型糖尿病患者的全因死亡风险

SGLT2抑制剂是一类机制新颖的抗高血糖药物,可降低II型糖尿病患者不良血管和肾脏事件的风险。在传统糖尿病治疗药物中,磺脲类药物是仅次于二甲双胍的,第二大广泛应用药物。近日研究人员比较了SGLT2抑制剂和磺脲类药物对II型糖尿病患者全因死亡率的影响。

本研究使用了美国退伍军人数据库数据,考察了,在二甲双胍治疗基础上,II型糖尿病患者使用SGLT2抑制剂和磺脲类药物的情况。在2016年10月1日至2020年2月29日期间,共有23870 人首次使用SGLT2抑制剂,104423 人首次使用磺脲类药物,并一直随访到2021年1月31日。研究的主要终点为全因死亡率。

参与者平均年龄为64.60岁,男性占95.17%。与磺酰脲类药物的比较,使用SGLT2抑制剂与患者全因死亡率降低相关(危险比[HR]=0.81),死亡事件差异为每1000患者随访年减少5.15人次死亡。使用SGLT2抑制剂对患者死亡风险的降低作用不受心血管疾病状况、肾小球滤过率以及蛋白尿情况的影响。在方案分析中,与继续使用磺脲类药物患者相比,继续使用SGLT2抑制剂可持续降低患者死亡风险(HR=0.66;事件差异:-10.10人次)。进一步分析显示,与未使用二甲双胍的单独SGLT2抑制剂治疗相比,继续SGLT2抑制剂与二甲双胍联合治疗与死亡风险降低相关(HR=0.70;事件差异:-7.62人次)。

研究认为,与磺脲类药物相比,使用二甲双胍-SGLT-2抑制剂联合治疗可降低II型糖尿病患者的全因死亡风险

原始出处:

Yan Xie et al. Comparative Effectiveness of Sodium-Glucose Cotransporter 2 Inhibitors vs Sulfonylureas in Patients With Type 2 Diabete. JAMA Intern Med. June 28,2021.

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    2021-11-02 tulenzi
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time=2021-07-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1475099, encodeId=1bdc14e5099ab, content=<a href='/topic/show?id=935fe6718e3' target=_blank style='color:#2F92EE;'>#糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76718, encryptionId=935fe6718e3, topicName=糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a38f7243741, createdName=xue8604, createdTime=Thu Jul 08 11:40:17 CST 2021, time=2021-07-08, status=1, ipAttribution=)]
    2021-11-11 jklm09
  5. 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time=2021-07-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1475099, encodeId=1bdc14e5099ab, content=<a href='/topic/show?id=935fe6718e3' target=_blank style='color:#2F92EE;'>#糖尿病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76718, encryptionId=935fe6718e3, topicName=糖尿病患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a38f7243741, createdName=xue8604, createdTime=Thu Jul 08 11:40:17 CST 2021, time=2021-07-08, status=1, ipAttribution=)]
  6. 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  7. 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