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在一家专科糖尿病诊所接受卡格列净治疗的2型糖尿病患者的真实世界临床结局:按基线糖化血红蛋白和年龄进行的亚组分析。

Real-world Clinical Outcomes Among Patients With Type 2 Diabetes Receiving Canagliflozin at a Specialty Diabetes Clinic: Subgroup Analysis by Baseline HbA and Age.

作者信息

Johnson June Felice, Parsa Rahul, Bailey Robert A

机构信息

Drake University College of Pharmacy and Health Sciences, Des Moines, Iowa.

College of Business, Iowa State University, Ames, Iowa.

出版信息

Clin Ther. 2017 Jun;39(6):1123-1131. doi: 10.1016/j.clinthera.2017.04.006. Epub 2017 May 9.

DOI:10.1016/j.clinthera.2017.04.006
PMID:28495028
Abstract

PURPOSE

Canagliflozin, a sodium glucose co-transporter 2 inhibitor developed for the treatment of type 2 diabetes mellitus (T2DM), has demonstrated effectiveness in patients with T2DM receiving care at a specialty diabetes clinic. We report the outcomes in these patients in subgroups classified by baseline hemoglobin A (HbA) and age.

METHODS

This subgroup analysis was based on a review of data from the electronic health records of adults with T2DM who were prescribed canagliflozin at a specialty diabetes clinic and who returned for ≥1 follow-up office visit. Mean changes from baseline to the first and second follow-up office visits in HbA, body weight, and systolic and diastolic blood pressure (BP) were calculated in each subgroup classified by baseline HbA (≥7.0%, ≥8.0%, and >9.0%) and age (<65 and ≥65 years).

FINDINGS

Of the 462 patients included in the study, 430, 305, and 169 patients had baseline HbA ≥7.0%, ≥8.0%, and >9.0%, respectively; 396 and 66 patients were aged <65 and ≥65 years, respectively. With canagliflozin use, patients across subgroups classified by baseline HbA and age experienced clinically and statistically significant reductions from baseline in HbA, body weight, and systolic BP that were sustained over 2 office visits; diastolic BP was also reduced across baseline HbA and age subgroups. Greater reductions in HbA were seen among the canagliflozin-treated patients with higher baseline HbA and among younger versus older patients.

IMPLICATION

These findings from clinical practice demonstrate real-world effectiveness of canagliflozin in lowering HbA, body weight, and systolic BP among patients with T2DM, regardless of baseline HbA levels or age.

摘要

目的

卡格列净是一种开发用于治疗2型糖尿病(T2DM)的钠葡萄糖协同转运蛋白2抑制剂,已在一家专科糖尿病诊所接受治疗的T2DM患者中显示出有效性。我们报告了这些患者按基线糖化血红蛋白(HbA)和年龄分类的亚组结果。

方法

该亚组分析基于对一家专科糖尿病诊所中开具卡格列净处方且返回进行≥1次随访门诊就诊的成年T2DM患者电子健康记录数据的回顾。在按基线HbA(≥7.0%、≥8.0%和>9.0%)和年龄(<65岁和≥65岁)分类的每个亚组中,计算从基线到首次和第二次随访门诊就诊时HbA、体重以及收缩压和舒张压(BP)的平均变化。

结果

在纳入研究的462例患者中,分别有430例、305例和169例患者的基线HbA≥7.0%、≥8.0%和>9.0%;分别有396例和66例患者年龄<65岁和≥65岁。使用卡格列净后,按基线HbA和年龄分类的各亚组患者的HbA、体重和收缩压较基线均出现了临床和统计学上的显著降低,且在2次门诊就诊期间持续存在;舒张压在各基线HbA和年龄亚组中也有所降低。在基线HbA较高的卡格列净治疗患者以及年轻患者与老年患者中,HbA降低幅度更大。

结论

这些来自临床实践的结果表明,无论基线HbA水平或年龄如何,卡格列净在降低T2DM患者的HbA、体重和收缩压方面具有实际疗效。

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