Scheen André J, Wallemacq Caroline, Jandrain Bernard, Ernest Philippe
Service de diabétologie, nutrition et maladies métaboliques, CHU Liège, 4000 Liège, Belgique.
Unité de pharmacologie clinique, CHU Liège, Université de Liège, 4000 Liège, Belgique.
Rev Med Suisse. 2016 Aug 24;12(527):1370-1375.
Two clinical trials demonstrate the superiority versus a placebo of two antidiabetic drugs in patients with type 2 diabetes and high cardiovascular risk. Empagliflozin, an inhibitor of sodium-glucose type 2 (SGLT2) cotransporters, in EMPA-REG OUTCOME, and liraglutide, an agonist of glucagon-like peptide-1 (GLP-1) receptors, in LEADER, showed a significant reduction in major cardiovascular events (- 14 and - 13 %, respectively), cardiovascular mortality (- 38 and - 22 %, respectively) and all-cause mortality (- 32 and - 15 %, respectively). A lower progression of kidney disease and less renal events were also reported. The underlying protective mechanisms remain controverted as the discussion whether the benefits are specific to each medication or could be extended to other molecules of these two pharmacological classes.
两项临床试验证明，两种抗糖尿病药物在2型糖尿病且心血管风险高的患者中比安慰剂更具优势。在EMPA-REG OUTCOME试验中的钠-葡萄糖协同转运蛋白2（SGLT2）抑制剂恩格列净，以及在LEADER试验中的胰高血糖素样肽-1（GLP-1）受体激动剂利拉鲁肽，均显示主要心血管事件显著减少（分别为-14%和-13%）、心血管死亡率显著降低（分别为-38%和-22%）以及全因死亡率显著降低（分别为-32%和-15%）。还报告了肾病进展减缓以及肾脏事件减少。由于关于这些益处是每种药物所特有的，还是可以扩展到这两个药理学类别的其他分子的讨论，其潜在的保护机制仍存在争议。
