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西他列汀在老年2型糖尿病患者中的安全性:25项临床研究的汇总分析。

Safety of sitagliptin in elderly patients with type 2 diabetes: a pooled analysis of 25 clinical studies.

作者信息

Round Elizabeth M, Engel Samuel S, Golm Gregory T, Davies Michael J, Kaufman Keith D, Goldstein Barry J

机构信息

Merck & Co., Inc., Whitehouse Station, NJ, USA,

出版信息

Drugs Aging. 2014 Mar;31(3):203-14. doi: 10.1007/s40266-014-0155-7.

DOI:10.1007/s40266-014-0155-7
PMID:24510656
Abstract

OBJECTIVE

The aim of this study was to evaluate the safety and tolerability of sitagliptin 100 mg/day in elderly patients with type 2 diabetes.

DESIGN

A post hoc pooled analysis of 25 randomized, double-blind, parallel group clinical studies with results available as of 1 December 2011.

SETTING

Multicenter, international clinical trials.

SUBJECTS

Patients with type 2 diabetes aged 65 years or older.

INTERVENTIONS

Patients were randomized to sitagliptin 100 mg/day (n = 1,261) or a comparator (n = 1,185) for 12 weeks to 2 years.

MAIN OUTCOME MEASURES

In each study, investigators reported serious and non-serious adverse events that occurred during the study, and serious adverse events occurring within 14 days following the last dose of study drug. This analysis used patient-level data from each study to assess the exposure-adjusted incidence rates of specific adverse events that occurred following initiation of study drug.

RESULTS

Summary measures of adverse events overall were similar between the sitagliptin and non-exposed (active comparator or placebo) groups, except for higher incidences of deaths and drug-related adverse events in the non-exposed group. Incidence rates of specific adverse events were generally similar between the two groups, with the exception of hypoglycemia. A lower incidence rate of hypoglycemia was observed in the sitagliptin group compared with the non-exposed group [7.0 vs. 14.3 per 100 patient-years; difference -7.6 (95 % CI -11.2 to -4.3]), primarily due to greater use of sulfonylureas in the non-exposed group.

CONCLUSIONS

In this pooled safety analysis of elderly patients with type 2 diabetes, treatment with sitagliptin 100 mg/day was generally well tolerated for up to 2 years.

摘要

目的

本研究旨在评估每日100毫克西他列汀在老年2型糖尿病患者中的安全性和耐受性。

设计

对截至2011年12月1日已有结果的25项随机、双盲、平行组临床研究进行事后汇总分析。

地点

多中心国际临床试验。

研究对象

65岁及以上的2型糖尿病患者。

干预措施

患者被随机分为每日100毫克西他列汀组(n = 1261)或对照药组(n = 1185),治疗12周至2年。

主要观察指标

在每项研究中,研究者报告研究期间发生的严重和非严重不良事件,以及最后一剂研究药物后14天内发生的严重不良事件。本分析使用每项研究的患者层面数据,以评估研究药物开始使用后特定不良事件的暴露调整发病率。

结果

除未暴露组(活性对照药或安慰剂)的死亡和药物相关不良事件发生率较高外,西他列汀组和未暴露组的总体不良事件汇总指标相似。两组特定不良事件的发生率一般相似,但低血糖除外。与未暴露组相比,西他列汀组低血糖发生率较低[每100患者年分别为7.0和14.3;差异-7.6(95%CI -11.2至-4.3)],主要原因是未暴露组更多使用磺脲类药物。

结论

在这项老年2型糖尿病患者的汇总安全性分析中,每日100毫克西他列汀治疗长达2年一般耐受性良好。

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Diabetes Obes Metab. 2014 Mar;16(3):223-30. doi: 10.1111/dom.12194. Epub 2013 Aug 29.
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Sitagliptin and pioglitazone provide complementary effects on postprandial glucose and pancreatic islet cell function.西格列汀和吡格列酮对餐后血糖和胰岛细胞功能具有互补作用。
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Safety and tolerability of sitagliptin in type 2 diabetes: pooled analysis of 25 clinical studies.
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Efficacy and safety of sitagliptin as compared with glimepiride in Japanese patients with type 2 diabetes mellitus aged ≥ 60 years (START-J trial).在年龄≥60 岁的日本 2 型糖尿病患者中比较西他列汀与格列美脲的疗效和安全性(START-J 试验)。
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