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合并心衰的2型糖尿病患者还能用DPP-4抑制剂吗

2014-01-20 高晓方 译 医学论坛网

据2013年世界糖尿病大会消息,多数专家表示,对已伴有心衰或心衰高危2型糖尿病患者不应排除应用DPP-4抑制剂,但需在治疗起始后6个月内密切监测。 SAVOR-TIMI 53试验表明,DPP-4抑制剂沙格列汀(saxagliptin)相关性心衰病例主要在药物启用后6个月内出现。在saxagliptin和对照组患者中,心衰住院率差异极小并且无统计学意义。无证据显示saxagliptin组患者在住院

据2013年世界糖尿病大会消息,多数专家表示,对已伴有心衰或心衰高危2型糖尿病患者不应排除应用DPP-4抑制剂,但需在治疗起始后6个月内密切监测。

SAVOR-TIMI 53试验表明,DPP-4抑制剂沙格列汀(saxagliptin)相关性心衰病例主要在药物启用后6个月内出现。在saxagliptin和对照组患者中,心衰住院率差异极小并且无统计学意义。无证据显示saxagliptin组患者在住院期间具有更为复杂的心衰病程。Saxagliptin可能会导致心衰风险轻度升高。由于EXAMINE研究显示另一种DPP-4抑制剂阿格列汀(alogliptin)亦可导致心衰住院呈升高趋势,因此心衰可能为DPP-4yi的类效应,但目前尚不清楚其机制。

一些心内科医生曾宣称,在更多资料出现之前,将不会对既存心衰的糖尿病患者应用DPP-4抑制剂。然而,由于心衰和低血糖风险相对较小,并且添加磺脲类或胰岛素亦可升高心衰风险,因此当既存心衰或心衰高危的2型糖尿病患者需要应用二甲双胍之外的降糖药时,仍可审慎考虑应用DPP-4抑制剂。

原文出处:

Lisa Nainggolan.DPP-4 Inhibitors and Heart Failure in Diabetes: Be Vigilant.Medscape December 10, 2013

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    2014-06-03 jklm09
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    2014-01-22 gaoxiaoe
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    2014-01-20 Hilda Bastian

    DDP-4类药物有更多的功能,因此,也意味着可能有不良反应

    0

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