Jabbour Serge
a Sidney Kimmel Medical College at Thomas Jefferson University , Philadelphia , PA , USA.
Curr Med Res Opin. 2017 Sep;33(9):1685-1696. doi: 10.1080/03007995.2017.1354822. Epub 2017 Jul 31.
Due to the chronic nature of type 2 diabetes (T2D), it is essential for an anti-diabetic drug to have durable efficacy and a good long-term safety profile. Dapagliflozin is a member of a unique class of anti-diabetic drugs that inhibit the sodium-glucose cotransporter 2 (SGLT-2) in the renal tubules and have an insulin-independent mechanism of action. In short-term studies (≤ 24 weeks), dapagliflozin reduced glycated hemoglobin (A1c), weight, and systolic blood pressure, and had a good safety profile.
This review summarizes the findings of long-term studies that evaluated the efficacy and safety of dapagliflozin.
These findings indicate that dapagliflozin is effective as monotherapy and in combination with other anti-hyperglycemic agents, including insulin and oral anti-diabetic therapies, in improving glycemic control and reducing blood pressure and weight for up to 4 years. The findings were fairly consistent across various patient populations with T2D, including those with cardiovascular disease (CVD) and mild renal impairment. Extended use of dapagliflozin was not associated with an increase in safety signals over time. Frequently observed adverse events (AEs) were consistent with the drug's mechanism of action and were generally mild in intensity. No substantial impact of dapagliflozin on renal function was observed, and findings show that the drug is safe in T2D patients with CVD or mild renal impairment, as well as elderly patients.
The findings across the studies support the use of dapagliflozin for the long-term treatment of T2D across a broad spectrum of patients.
由于2型糖尿病(T2D)具有慢性特点,一种抗糖尿病药物具备持久疗效和良好的长期安全性至关重要。达格列净是一类独特的抗糖尿病药物的成员,这类药物可抑制肾小管中的钠-葡萄糖协同转运蛋白2(SGLT-2),具有非胰岛素依赖的作用机制。在短期研究(≤24周)中,达格列净可降低糖化血红蛋白(A1c)、体重和收缩压,且安全性良好。
本综述总结了评估达格列净疗效和安全性的长期研究结果。
这些结果表明,达格列净作为单一疗法以及与其他抗高血糖药物(包括胰岛素和口服抗糖尿病疗法)联合使用时,在改善血糖控制、降低血压和体重方面有效,且长达4年。在包括患有心血管疾病(CVD)和轻度肾功能损害的各种T2D患者群体中,研究结果相当一致。随着时间的推移,达格列净的长期使用与安全信号增加无关。常见的不良事件(AE)与药物的作用机制一致,强度一般较轻。未观察到达格列净对肾功能有实质性影响,研究结果表明该药物在患有CVD或轻度肾功能损害的T2D患者以及老年患者中是安全的。
各项研究的结果支持在广泛的患者群体中使用达格列净进行T2D的长期治疗。