Toft Eva, Rydén Mikael
Karolinska Institutet - Medicine (H7) Stockholm, Sweden Karolinska Institutet - Medicine (H7) Stockholm, Sweden.
Karolinska University Hospital - Department of Endokrinology Stockholm, Sweden - , Sweden.
Lakartidningen. 2018 Feb 20;115:EYWU.
Do novel therapies in type 2 diabetes have protective effects on cardiovascular and renal complications? A number of new antidiabetic drug classes have been introduced on the market in the last decade. Regulatory authorities have required that their safety in type 2 diabetes populations with high cardiovascular risk must be assessed. Consequently, a large number of outcome studies have been initiated, several of which have been published in recent years. Overall, this has so far shown that long-acting insulin analogues, DPP4-inhibitors, GLP1-receptor agonists and SGLT2-inhibitors are safe. In addition, a few select agents within the latter two classes have been shown to be superior to placebo with respect to cardiovascular as well as renal outcomes. This review summarizes these recent trials and discusses how the results can be interpreted. It is important to emphasize that the subjects included in these studies had/have high risk for or manifest cardiovascular disease. Therefore, the results cannot be extrapolated to all individuals with type 2 diabetes.
2型糖尿病的新型疗法对心血管和肾脏并发症有保护作用吗？在过去十年中，市场上推出了许多新型抗糖尿病药物类别。监管机构要求必须评估它们在心血管风险高的2型糖尿病人群中的安全性。因此，已经启动了大量结局研究，其中一些研究近年来已经发表。总体而言，到目前为止的研究表明，长效胰岛素类似物、二肽基肽酶4（DPP4）抑制剂、胰高血糖素样肽1（GLP1）受体激动剂和钠-葡萄糖协同转运蛋白2（SGLT2）抑制剂是安全的。此外，后两类中的一些精选药物在心血管和肾脏结局方面已被证明优于安慰剂。本综述总结了这些近期试验，并讨论了如何解释这些结果。需要强调的是，这些研究纳入的受试者患有心血管疾病或有患心血管疾病的高风险。因此，这些结果不能外推至所有2型糖尿病患者。
