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Diabetes Care:SGLT2抑制剂服用者发生急性肾损伤的风险分析!

2017-08-22 xing.T MedSci原创

由此可见,该研究结果并未表明AKI风险增加与T2D患者服用SGLT2抑制剂有关。

钠-葡萄糖转运体2(SGLT2)抑制剂是一种新药物,可以改善2型糖尿病患者的心血管疾病和肾脏结局。然而,美国食品和药物管理局对于canagliflozin和dapagliflozin增加急性肾损伤(AKI)的风险已发出警报。近日,糖尿病领域权威杂志Diabetes Care上发表了研究文章,研究人员旨在通过两个大型卫生服务使用T2D患者队列来评估服用SGLT2抑制剂发生的AKI风险。

研究人员使用了西奈山慢性肾脏病注册中心和Geisinger健康系统队列的纵向数据进行分析。研究人员选择了SGLT抑制剂使用者和非使用者(没有服用SGLT2抑制剂的患者)。研究人员通过KDIGO定义来诊断AKI(AKI-KDIGO)。在主要分析和敏感性分析中,研究人员进行了1:1近邻倾向匹配并计算了AKI未经调整的风险比(HR)和调整后的HR(aHRs)。

在西奈山队列研究中,研究人员确定了377名SGLT2抑制剂服用者和377名非使用者,其中分别有3.8和9.7%的参与者在14个月的中位随访期间发生AKI-KDIGO事件。在SGLT2抑制剂服用者中,AKI-KDIGO未经调整后的风险下降了60%(HR为0.4,95%CI为0.2-0.7;P=0.01),在进行调整后,风险没有变化(aHR为0.4,95%CI为0.2-0.7;P=0.004)。同样地,研究人员在Geisinger队列中确定了1207名SGLT2抑制剂服用者和1207名非使用者,其中分别有2.2%和4.6%的患者发生了AKI-KDIGO事件。在SGLT2抑制剂服用者中,AKI-KDIGO调整后的风险较低(HR为0.5,95%CI为0.3-0.8;P<0.01),在调整协变量后,有所降低(aHR为0.6,95%CI为0.4-1.1;P=0.09)。在一系列敏感性分析中,这些估计并没有发生本质的改变。

由此可见,该研究结果并未表明AKI风险增加与T2D患者服用SGLT2抑制剂有关。

原始出处:

Girish N. Nadkarni,et al. Acute Kidney Injury in Patients on SGLT2 Inhibitors: A Propensity-Matched Analysis.Diabetes Care 2017 Aug. https://doi.org/10.2337/dc17-1011

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    2018-05-31 tulenzi
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    2017-11-09 jklm09
  5. 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  6. 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  7. 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objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Wed Sep 06 23:50:14 CST 2017, time=2017-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=240065, encodeId=d3972400652d, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Sun Sep 03 16:38:51 CST 2017, time=2017-09-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=238403, encodeId=1d2c23840363, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Tue Aug 29 19:56:13 CST 2017, time=2017-08-29, status=1, ipAttribution=)]
    2017-09-08 哈哈869

    学了

    0

  8. 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channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5916, encryptionId=afda591646, topicName=DIA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=987022654425, createdName=ms9608593228839890, createdTime=Sat May 12 07:07:00 CST 2018, time=2018-05-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=241616, encodeId=0648241616c6, content=学了, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Fri Sep 08 06:42:54 CST 2017, time=2017-09-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=241222, encodeId=bac1241222f6, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Wed Sep 06 23:50:14 CST 2017, time=2017-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=240065, encodeId=d3972400652d, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Sun Sep 03 16:38:51 CST 2017, time=2017-09-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=238403, encodeId=1d2c23840363, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Tue Aug 29 19:56:13 CST 2017, time=2017-08-29, status=1, ipAttribution=)]
    2017-09-06 哈哈869

    学习

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1793789, encodeId=5fa31e93789cf, content=<a href='/topic/show?id=5a3f1621e7d' target=_blank style='color:#2F92EE;'>#SGLT#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=16217, encryptionId=5a3f1621e7d, topicName=SGLT)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=54f9127, createdName=tulenzi, createdTime=Thu May 31 05:07:00 CST 2018, time=2018-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1995494, encodeId=e73f199549468, content=<a href='/topic/show?id=992411149e' target=_blank style='color:#2F92EE;'>#2抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1114, encryptionId=992411149e, topicName=2抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=55683, 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channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5916, encryptionId=afda591646, topicName=DIA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=987022654425, createdName=ms9608593228839890, createdTime=Sat May 12 07:07:00 CST 2018, time=2018-05-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=241616, encodeId=0648241616c6, content=学了, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Fri Sep 08 06:42:54 CST 2017, time=2017-09-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=241222, encodeId=bac1241222f6, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Wed Sep 06 23:50:14 CST 2017, time=2017-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=240065, encodeId=d3972400652d, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Sun Sep 03 16:38:51 CST 2017, time=2017-09-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=238403, encodeId=1d2c23840363, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Tue Aug 29 19:56:13 CST 2017, time=2017-08-29, status=1, ipAttribution=)]
    2017-09-03 哈哈869

    学习

    0

  10. 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objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Wed Sep 06 23:50:14 CST 2017, time=2017-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=240065, encodeId=d3972400652d, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Sun Sep 03 16:38:51 CST 2017, time=2017-09-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=238403, encodeId=1d2c23840363, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Tue Aug 29 19:56:13 CST 2017, time=2017-08-29, status=1, ipAttribution=)]
    2017-08-29 哈哈869

    学习

    0

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Lancet Diabetes Endo:SGLT2抑制剂对2型糖尿病患者心血管健康的影响

目的对2型糖尿病患者而言,使用SGLT2抑制剂可降低机体血糖水平、血压、体重,但会增加低密度脂蛋白胆固醇水平和泌尿生殖系感染的发病率。有研究指出SGLT2抑制剂具有预防心血管事件的作用,也有研究指出它可增加民众出现酮症酸中毒和骨折的风险。该研究旨在探究成人2型糖尿病患者使用SGLT2抑制剂出现心血管事件、死亡等的发生率,并评估药物的安全性能。 方法该研究为系统性回顾和荟萃分析,研究人员使用MEDL

FDA警告:糖尿病治疗新秀“SGLT2抑制剂”导致酮症酸中毒风险

近年来,钠-葡萄糖2型转运体(SGLT2)作为一个治疗糖尿病的新靶点受到广泛关注。SGLT2是一类特异性分布在肾脏近曲小管S1段的葡萄糖转运体,其生理功能是负责约90%葡萄糖的重吸收。SGLT2抑制剂通过抑制SGLT2,从而减少肾脏对葡萄糖的重吸收,增加尿糖排出,降低血糖。近期FDA更新SGLT2抑制剂标签,强调该药物酮症酸中毒和严重的尿路感染风险,这两种疾病均会导致住院治疗。2015年5月,FD

JACC:在2型糖尿病老年患者中,钠-葡萄糖协同转运蛋白2(SGLT2)抑制剂可降低心血管和心脏衰竭风险。

2型糖尿病(T2DM)患者的钠-葡萄糖协同转运蛋白2(SGLT2)抑制剂可降低心血管和心脏衰竭风险。

Lancet diabetes endo:钠-葡萄糖共转运体抑制剂与其他降糖药物治疗2型糖尿病患者时心血管意外的发生率和死亡率对比。

研究表明钠-葡萄糖共转运体-2(SGLT2)抑制剂empagliflozin(依帕列净)和canagliflozin(卡格列净)可降低心血管意外高风险的2型糖尿病患者心血管意外的发生率和死亡率。在广泛有心血管意外风险的人群中,SGLT2抑制剂的新使用患者和其他降糖药的新使用患者心血管意外的发生率和死亡率是否存在差异?

FDA专家组12:11支持SGLT2抑制剂Jardiance标签扩展

昨天FDA内分泌与代谢药物专家组以12票支持、11反对的微弱优势支持礼来和BI的SGLT2抑制剂Jardiance降低心血管死亡的标签扩展。FDA将在今年9月做出最后裁决。 现在所有的糖尿病药物都是根据降糖疗效批准。自2007年Avandia事件后所有新药要显示可以安全降糖,即没有心血管副作用。去年一个叫做EMPA-REG的四期临床试验显示使用3年Jardiance可以降低38%的心脏病死亡

Diabetes:二甲双胍和SGLT2抑制剂组合有效降低血糖水平

根据Diabetes杂志上的一项新研究证实:二甲双胍和SGLT2抑制剂组合后,可更有效地降低血糖水平,两药组合的降血糖功效显着高于单独用药。 在糖尿病的治疗中,不同口服的抗糖尿病药中的各种活性物质经常会组合在一起,以达到更有效降低血糖的目的。一种新的,非常有前途的方法:二甲双胍结合SGLT2抑制剂在2012年被批准。 Martin Hrabě de Angelis博士和Ludwig-M

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