Pratley Richard E, Cersosimo Eugenio
Translational Research Institute for Metabolism and Diabetes, Florida Hospital Diabetes Institute and Sanford Burnham Prebys Medical Discovery Institute, Orlando, FL.
Texas Diabetes Institute, University Health System and the University of Texas Health Science Center at San Antonio, San Antonio, TX.
Clin Diabetes. 2017 Jul;35(3):141-153. doi: 10.2337/cd16-0063.
Sodium-glucose cotransporter 2 (SGLT2) inhibitors and incretin-based therapies (dipeptidyl peptidase-4 [DPP-4] inhibitors and glucagon-like peptide-1 [GLP-1] receptor agonists) are widely used to treat patients with type 2 diabetes. In clinical and real-world studies, canagliflozin, an SGLT2 inhibitor, has demonstrated superior A1C lowering compared to the DPP-4 inhibitor sitagliptin. Canagliflozin can also promote modest weight/fat loss and blood pressure reduction. The addition of canagliflozin to treatment regimens that include a DPP-4 inhibitor or a GLP-1 receptor agonist has been shown to further improve glycemic control, while still maintaining beneficial effects on cardiometabolic parameters such as body weight and blood pressure. Overall, the available clinical and real-world evidence suggests that canagliflozin is a safe and well-tolerated treatment option that can be considered either in addition to or instead of incretin-based therapies for patients with type 2 diabetes.
钠-葡萄糖协同转运蛋白2(SGLT2)抑制剂和基于肠促胰素的疗法(二肽基肽酶-4 [DPP-4]抑制剂和胰高血糖素样肽-1 [GLP-1]受体激动剂)被广泛用于治疗2型糖尿病患者。在临床和实际研究中,SGLT2抑制剂卡格列净与DPP-4抑制剂西他列汀相比,已显示出更优的糖化血红蛋白(A1C)降低效果。卡格列净还可促进适度的体重/脂肪减轻和血压降低。在包含DPP-4抑制剂或GLP-1受体激动剂的治疗方案中添加卡格列净已被证明可进一步改善血糖控制,同时仍对体重和血压等心脏代谢参数保持有益作用。总体而言,现有的临床和实际证据表明卡格列净是一种安全且耐受性良好的治疗选择,对于2型糖尿病患者,可考虑在基于肠促胰素的疗法之外使用或取而代之。