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本文引用的文献

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Empagliflozin and Progression of Kidney Disease in Type 2 Diabetes.恩格列净与 2 型糖尿病患者的肾脏疾病进展。
N Engl J Med. 2016 Jul 28;375(4):323-34. doi: 10.1056/NEJMoa1515920. Epub 2016 Jun 14.
2
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N Engl J Med. 2015 Nov 26;373(22):2117-28. doi: 10.1056/NEJMoa1504720. Epub 2015 Sep 17.
3
Diabetic Ketoacidosis and Related Events in the Canagliflozin Type 2 Diabetes Clinical Program.卡格列净治疗2型糖尿病临床项目中的糖尿病酮症酸中毒及相关事件
Diabetes Care. 2015 Sep;38(9):1680-6. doi: 10.2337/dc15-1251. Epub 2015 Jul 22.
4
Effect of Sitagliptin on Cardiovascular Outcomes in Type 2 Diabetes.西格列汀对 2 型糖尿病患者心血管结局的影响。
N Engl J Med. 2015 Jul 16;373(3):232-42. doi: 10.1056/NEJMoa1501352. Epub 2015 Jun 8.
5
Standards of medical care in diabetes-2015 abridged for primary care providers.《2015年糖尿病医疗护理标准》(初级医疗服务提供者简版)
Clin Diabetes. 2015 Apr;33(2):97-111. doi: 10.2337/diaclin.33.2.97.
6
Management of hyperglycemia in type 2 diabetes, 2015: a patient-centered approach: update to a position statement of the American Diabetes Association and the European Association for the Study of Diabetes.2015年2型糖尿病高血糖管理:以患者为中心的方法:美国糖尿病协会和欧洲糖尿病研究协会立场声明更新版
Diabetes Care. 2015 Jan;38(1):140-9. doi: 10.2337/dc14-2441.
7
A Novel Therapeutic Agent for Type 2 Diabetes Mellitus: SGLT2 Inhibitor.用于 2 型糖尿病的新型治疗药物:SGLT2 抑制剂。
Diabetes Metab J. 2014 Aug;38(4):261-73. doi: 10.4093/dmj.2014.38.4.261.
8
Safety of dipeptidyl peptidase 4 inhibitors: a perspective review.二肽基肽酶 4 抑制剂的安全性:观点综述。
Ther Adv Drug Saf. 2014 Jun;5(3):138-46. doi: 10.1177/2042098614523031.
9
Dipeptidyl peptidase-4 inhibitors can minimize the hypoglycaemic burden and enhance safety in elderly people with diabetes.二肽基肽酶-4 抑制剂可最大限度减少低血糖负担并提高老年糖尿病患者的安全性。
Diabetes Obes Metab. 2015 Feb;17(2):107-15. doi: 10.1111/dom.12319. Epub 2014 Jun 25.
10
Dipeptidyl peptidase-4 inhibitors and cardiovascular outcomes: meta-analysis of randomized clinical trials with 55,141 participants.二肽基肽酶-4抑制剂与心血管结局:对55141名参与者的随机临床试验的荟萃分析
Cardiovasc Ther. 2014 Aug;32(4):147-58. doi: 10.1111/1755-5922.12075.

在真实临床环境中,与西格列汀相比,使用卡格列净治疗的2型糖尿病患者的短期结局。

Short-term outcomes of patients with Type 2 diabetes mellitus treated with canagliflozin compared with sitagliptin in a real-world setting.

作者信息

Shao Yan Li, Yee Kuan Hao, Koh Seow Ken, Wong Yip Fong, Yeoh Lee Ying, Low Serena, Sum Chee Fang

机构信息

Diabetes Centre, Admiralty Medical Centre and Khoo Teck Puat Hospital, Singapore.

National University of Ireland, Ireland.

出版信息

Singapore Med J. 2018 May;59(5):251-256. doi: 10.11622/smedj.2017095. Epub 2017 Oct 12.

DOI:10.11622/smedj.2017095
PMID:29022040
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5966634/
Abstract

INTRODUCTION

We aimed to evaluate the effectiveness and safety of canagliflozin as compared to sitagliptin in a real-world setting among multiethnic patients with Type 2 diabetes mellitus (T2DM) in Singapore.

METHODS

This was a new-user, active-comparator, single-centre retrospective cohort study. Patients aged 18-69 years with T2DM and estimated glomerular filtration rate ≥ 60 mL/min/1.73 m were eligible for inclusion if they were initiated and maintained on a steady daily dose of canagliflozin 300 mg or sitagliptin 100 mg between 1 May and 31 December 2014, and followed up for 24 weeks.

RESULTS

In total, 57 patients (canagliflozin 300 mg, n = 22; sitagliptin 100 mg, n = 35) were included. The baseline patient characteristics in the two groups were similar, with overall mean glycated haemoglobin (HbA1c) of 9.4% ± 1.4%. The use of canagliflozin 300 mg was associated with greater reductions in HbA1c (least squares [LS] mean change -1.6% vs. -0.4%; p < 0.001), body weight (LS mean change -3.0 kg vs. 0.2 kg; p < 0.001) and systolic blood pressure (LS mean change: -9.7 mmHg vs. 0.4 mmHg; p < 0.001), as compared with sitagliptin 100 mg. About half of the patients on canagliflozin 300 mg reported mild osmotic diuresis-related side effects that did not lead to drug discontinuation.

CONCLUSION

Our findings suggest that canagliflozin was more effective than sitagliptin in reducing HbA1c, body weight and systolic blood pressure in patients with T2DM, although its use was associated with an increased incidence of mild osmotic diuresis-related side effects.

摘要

简介

我们旨在评估在新加坡多民族2型糖尿病(T2DM)患者的真实环境中,与西他列汀相比,卡格列净的有效性和安全性。

方法

这是一项新使用者、活性对照、单中心回顾性队列研究。年龄在18 - 69岁、患有T2DM且估计肾小球滤过率≥60 mL/min/1.73 m² 的患者,如果在2014年5月1日至12月31日期间开始并维持每日稳定剂量的300 mg卡格列净或100 mg西他列汀,并随访24周,则符合纳入条件。

结果

总共纳入了57例患者(300 mg卡格列净组,n = 22;100 mg西他列汀组,n = 35)。两组患者的基线特征相似,总体糖化血红蛋白(HbA1c)平均为9.4% ± 1.4%。与100 mg西他列汀相比,使用300 mg卡格列净可使HbA1c(最小二乘法[LS]平均变化 -1.6% 对 -0.4%;p < 0.001)、体重(LS平均变化 -3.0 kg对0.2 kg;p < 0.001)和收缩压(LS平均变化:-9.7 mmHg对0.4 mmHg;p < 0.001)有更大幅度的降低。约一半服用300 mg卡格列净的患者报告有轻度渗透性利尿相关副作用,但未导致停药。

结论

我们的研究结果表明,在降低T2DM患者的HbA1c、体重和收缩压方面,卡格列净比西他列汀更有效,尽管其使用与轻度渗透性利尿相关副作用的发生率增加有关。