Weill Cornell Medical College, 525 East 68th Street, Baker Pavilion 20th Floor, NY 10021, USA.
J Comp Eff Res. 2014 Jan;3(1):29-39. doi: 10.2217/cer.13.87.
To provide evidence on the comparative effectiveness of oral diabetes drug combinations.
We performed a retrospective, observational cohort study of glycosylated hemoglobin change in outpatients newly exposed to dual- or triple-drug oral diabetes treatment.
Adjusted response to a second drug added to metformin ranged from 0.85 to 1.21% glycosylated hemoglobin decline. Response to a third drug was smaller (0.53-0.91%). Higher baseline glycosylated hemoglobin was associated with larger response; sulfonylurea effectiveness declined over time; and thiazolidinediones were more effective in obese patients and women.
Observational data provide results qualitatively consistent with the limited available randomized data on diabetes drug effectiveness, and extend these findings into common clinical scenarios where randomized data are unavailable. Sex and BMI influence the comparative effectiveness of diabetes drug combinations.
提供口服糖尿病药物联合治疗比较效果的证据。
我们对新接受二甲双胍双联或三联口服糖尿病治疗的门诊患者的糖化血红蛋白变化进行了回顾性、观察性队列研究。
加用第二种药物后，糖化血红蛋白下降的调整反应在 0.85%到 1.21%之间。加用第三种药物的反应较小（0.53%到 0.91%）。较高的基线糖化血红蛋白与更大的反应相关；磺酰脲类药物的有效性随时间下降；噻唑烷二酮类药物在肥胖患者和女性中更有效。
观察性数据提供的结果与有限的可用随机糖尿病药物有效性数据定性一致，并将这些发现扩展到随机数据不可用的常见临床情况下。性别和 BMI 影响糖尿病药物联合治疗的比较效果。
