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Ann Intern Med：钠-葡萄糖协同转运蛋白-2抑制剂与严重尿路感染风险

2019-08-05 xing.T MedSci原创

钠-葡萄糖协同转运蛋白-2抑制剂严重尿路感染风险
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由此可见，在常规临床实践中观察到的大量患者中，SGLT-2抑制剂治疗的患者发生严重和非严重UTI事件的风险与使用其他二线抗糖尿病药物治疗的患者相似。

先前报告钠-葡萄糖协同转运蛋白-2（SGLT-2）抑制剂评估严重尿路感染（UTI）风险的研究出现了相互矛盾的结果。近日，内科学权威杂志Annals of Internal Medicine上发表了一篇研究文章，该研究旨在评估与使用二肽基肽酶-4（DPP-4）抑制剂或胰高血糖素样肽-1受体（GLP-1）激动剂相比，使用SGLT-2抑制剂患者是否增加严重UTI事件的风险。

该研究为基于人群的队列研究，以2个美国大型商业索赔数据库（2013年3月至2015年9月）为基础，在每个数据库中，创建了2个队列，并在倾向得分上以1：1进行匹配。患者年龄在18岁或以上，患有2型糖尿病，并且开始使用SGLT-2抑制剂与DPP-4抑制剂（队列1）或GLP-1激动剂（队列2）。该研究的主要结局是严重的UTI事件，定义为原发性UTI住院、UTI败血症或肾盂肾炎; 次要结局是用抗生素治疗的门诊UTI。在每个倾向评分匹配的队列中估计风险比[HRs]，调整了超过90个基线特征。

在倾向评分1：1匹配后，在队列1中识别出123752名患者，在队列2中识别出111978名患者。在队列1中，新接受SGLT-2抑制剂的患者有61次严重UTI事件（发病率[IR]为1000人每年1.76人），而DPP-4抑制剂组中有57例（IR为1.77）（HR为0.98 [95％CI为0.68至1.41]）。在队列2中，与GLP-1激动剂组中的87次事件（IR为2.96）相比，接受SGLT-2抑制剂的患者有73次事件（IR为2.15）（HR为0.72 [CI为0.53至0.99]）。在敏感性分析中，调查结果非常稳健。此外，SGLT-2抑制剂与门诊UTI风险增加无关（队列1：HR为0.96 [CI为0.89至1.04];队列2：HR为0.91 [CI为0.84至0.99]）。

由此可见，在常规临床实践中观察到的大量患者中，SGLT-2抑制剂治疗的患者发生严重和非严重UTI事件的风险与使用其他二线抗糖尿病药物治疗的患者相似。 

原始出处：

Chintan V. Dave,et al.Sodium–Glucose Cotransporter-2 Inhibitors and the Risk for Severe Urinary Tract Infections: A Population-Based Cohort Study.AIM.2019.https://annals.org/aim/article-abstract/2739786/sodium-glucose-cotransporter-2-inhibitors-risk-severe-urinary-tract-infections

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    2019-10-04 yzh409

    #转运#

    0

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    2020-01-07 jklm19

    #钠-葡萄糖协同转运蛋白-2抑制剂#

    0

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    2020-01-13 liuquan

    #2抑制剂#

    0

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    2019-10-18 jklm09

    #抑制剂#

    0

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    2019-08-06 d830377

    #严重尿路感染#

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1696344, encodeId=7ad9169634477, content=<a href='/topic/show?id=0107934e0a5' target=_blank style='color:#2F92EE;'>#转运#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93470, encryptionId=0107934e0a5, topicName=转运)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=47c429881595, createdName=yzh409, createdTime=Fri Oct 04 14:35:00 CST 2019, time=2019-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1691565, encodeId=74181691565f2, content=<a href='/topic/show?id=d3349643968' target=_blank style='color:#2F92EE;'>#钠-葡萄糖协同转运蛋白-2抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96439, encryptionId=d3349643968, topicName=钠-葡萄糖协同转运蛋白-2抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5c9529239665, createdName=jklm19, createdTime=Tue Jan 07 22:35:00 CST 2020, time=2020-01-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1995566, encodeId=82b619955661c, 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=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1114, encryptionId=992411149e, topicName=2抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=28b7142, createdName=liuquan, createdTime=Mon Jan 13 11:35:00 CST 2020, time=2020-01-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1852073, encodeId=504018520e3ee, 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=43, 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 Oct 18 03:35:00 CST 2019, time=2019-10-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1552099, encodeId=4c94155209978, content=<a href='/topic/show?id=e9d5211e313' target=_blank style='color:#2F92EE;'>#严重尿路感染#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=21173, encryptionId=e9d5211e313, topicName=严重尿路感染)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8ead14256934, createdName=d830377, createdTime=Tue Aug 06 23:35:00 CST 2019, time=2019-08-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1609916, encodeId=6fb5160991667, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Tue Aug 06 23:35:00 CST 2019, time=2019-08-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=370846, encodeId=b9d13e084696, content=要做到科研与实践完美结合, beContent=null, objectType=article, channel=null, level=null, likeNumber=185, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2018/12/05/9151d1e89e73add788e7d96c55fb5dec.jpg, createdBy=dcfd2497546, createdName=124902dfm95暂无昵称, createdTime=Tue Aug 06 07:18:04 CST 2019, time=2019-08-06, status=1, ipAttribution=)]
    2019-08-06 ms3994565386320060

    #Med#

    0

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    2019-08-06 124902dfm95暂无昵称

    要做到科研与实践完美结合

    0

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