Dailey G E
Scripps Clinic and Scripps Whittier Diabetes Institute, La Jolla, California, USA.
Drugs Today (Barc). 2015 Sep;51(9):519-35. doi: 10.1358/dot.2015.51.9.2368554.
Empagliflozin is an oral sodium-glucose cotransporter 2 (SGLT2) inhibitor that reduces hyperglycemia in type 2 diabetes mellitus (T2DM) by decreasing renal glucose reabsorption and promoting urinary glucose excretion. In clinical trials, empagliflozin demonstrated significant improvements in glycemic control, as monotherapy and in combination regimens. In addition, empagliflozin was associated with weight loss and moderate reductions in blood pressure. In the EMPA-REG OUTCOME study, empagliflozin significantly reduced the risk of the composite primary endpoint of cardiovascular death, nonfatal myocardial infarction and nonfatal stroke. Across the trials in general, empagliflozin was well tolerated, with no increased risk of hypoglycemia except when used with an insulin secretagogue or insulin. An increased risk of genital infections and urinary tract infections has been reported, although the association is less clear for urinary tract infections. Overall, empagliflozin appears to be a promising treatment for T2DM.
恩格列净是一种口服钠-葡萄糖协同转运蛋白2(SGLT2)抑制剂,通过减少肾脏对葡萄糖的重吸收和促进尿糖排泄来降低2型糖尿病(T2DM)患者的高血糖水平。在临床试验中,恩格列净作为单药治疗和联合治疗方案,均显示出在血糖控制方面有显著改善。此外,恩格列净与体重减轻和血压适度降低有关。在EMPA-REG OUTCOME研究中,恩格列净显著降低了心血管死亡、非致死性心肌梗死和非致死性卒中复合主要终点的风险。总体而言,在各项试验中,恩格列净耐受性良好,除了与胰岛素促分泌剂或胰岛素合用时,低血糖风险没有增加。虽然关于尿路感染的关联尚不太明确,但已报告生殖器感染和尿路感染的风险增加。总体而言,恩格列净似乎是一种有前景的T2DM治疗药物。