西他列汀在老年2型糖尿病患者中的疗效与安全性及联合用药降糖作用比较：JAMP研究的亚组分析
Efficacy and safety of sitagliptin in elderly patients with type 2 diabetes mellitus and comparison of hypoglycemic action of concomitant medications: a subanalysis of the JAMP study.
作者信息
Ujihara Noriko, Sakura Hiroshi, Hashimoto Naotake, Sasamoto Kazuo, Ohashi Hiroshi, Hasumi Sumiko, Kasahara Tadasu, Tomonaga Osamu, Nunome Hideo, Honda Masashi, Iwamoto Yasuhiko
机构信息
1Department of Medicine, Diabetes Center, Institute of Geriatrics, Tokyo Women's Medical University, Shibuya Cross Tower 21F, 2-15-1, Shibuya, Shibuya-ku, Tokyo, 150-0002 Japan.
2Department of Medicine, Tokyo Women's Medical University, Medical Center East, 2-1-10 Nishiogu, Arakawa-ku, Tokyo, 116-8567 Japan.
出版信息
Diabetol Int. 2017 Jul 28;9(1):56-65. doi: 10.1007/s13340-017-0330-2. eCollection 2018 Feb.
PURPOSE
To determine the efficacy and safety of sitagliptin when used with some therapeutic drugs to treat elderly patients.
METHODS
Sitagliptin (50 mg/day) was added to the pre-existing therapy for type 2 diabetes. Changes in the glycated hemoglobin (HbA1c) level after 3 months of treatment were compared with the baseline, and exploratory analysis was performed. These analyses were conducted as subanalyses of the JAMP study, which was an open-label observational study.
RESULTS
For patients who were ≥65 years of age, the change in HbA1c level from baseline ranged from -0.50 to -0.87% at 3 months after starting treatment. There was no significant difference in the change in HbA1c level between the patients treated with different concomitant drugs. No significant difference in HbA1c variations at 3 and 12 months from baseline was noted among the three age groups (≥75, 65-74, and <65 years). Multiple regression analysis was performed, and it revealed that patients with higher HbA1c levels at baseline were likely to show decreased HbA1c levels, while those with higher triglyceride (TG) levels were unlikely to show decreased HbA1c levels.
CONCLUSION
Sitagliptin has the potential to both improve glycemic control and prevent hypoglycemia, and can be considered a potent alternative drug.
目的
确定西格列汀与某些治疗药物联合使用治疗老年患者的疗效和安全性。
方法
在2型糖尿病患者原有的治疗方案基础上加用西格列汀（50毫克/天）。将治疗3个月后糖化血红蛋白（HbA1c）水平的变化与基线水平进行比较，并进行探索性分析。这些分析作为JAMP研究的亚分析进行，JAMP研究是一项开放标签观察性研究。
结果
对于年龄≥65岁的患者，开始治疗3个月后HbA1c水平相对于基线的变化范围为-0.50%至-0.87%。使用不同联合药物治疗的患者之间HbA1c水平的变化无显著差异。在三个年龄组（≥75岁、65 - 74岁和<65岁）中，从基线起3个月和12个月时HbA1c变化无显著差异。进行了多元回归分析，结果显示基线时HbA1c水平较高的患者HbA1c水平可能降低，而甘油三酯（TG）水平较高的患者HbA1c水平不太可能降低。
结论
西格列汀有改善血糖控制和预防低血糖的潜力，可被视为一种有效的替代药物。
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