Shao Yan Li, Yee Kuan Hao, Koh Seow Ken, Wong Yip Fong, Yeoh Lee Ying, Low Serena, Sum Chee Fang
Diabetes Centre, Admiralty Medical Centre and Khoo Teck Puat Hospital, Singapore.
National University of Ireland, Ireland.
Singapore Med J. 2018 May;59(5):251-256. doi: 10.11622/smedj.2017095. Epub 2017 Oct 12.
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.
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.
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.
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.
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。
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。
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。
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。