Late-stage Development Cardiovascular Renal and Metabolism, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden.
Clinical Pharmacy and Pharmacology, University Medical Center Groningen, Groningen, the Netherlands; George Institute for Global Health, Sydney, Australia.
J Diabetes Complications. 2020 Dec;34(12):107729. doi: 10.1016/j.jdiacomp.2020.107729. Epub 2020 Sep 5.
Anemia is common in type 2 diabetes (T2D), particularly in patients with kidney impairment, and often goes unrecognized. Dapagliflozin treatment increases hemoglobin and serum erythropoietin levels. We investigated the effect of dapagliflozin 10-mg/day on hemoglobin in T2D patients with and without anemia.
Data from 5325 patients from 14 placebo-controlled, dapagliflozin-treatment studies of at least 24-weeks duration were pooled. Dapagliflozin's effects (vs. placebo) on hemoglobin, serum albumin, estimated glomerular filtration rate (eGFR), systolic blood pressure, body weight, and safety in patients with and without anemia were evaluated.
At baseline, 13% of all T2D patients and 28% of those with chronic kidney disease (eGFR <60 mL/min/1.73 m) had anemia. Hemoglobin increased continuously to at least week 8 and was sustained throughout 24-weeks follow-up in dapagliflozin-treated patients. Serum albumin increased in dapagliflozin-treated patients at week 4 and remained stable thereafter. Dapagliflozin was well tolerated and corrected anemia in 52% of patients with anemia at baseline (placebo: 26%). Incidences of new-onset anemia were lower in dapagliflozin-treated (2.3%) versus placebo-treated (6.5%) patients.
Treatment with dapagliflozin can correct and prevent anemia in T2D patients. A gradual increase in hemoglobin beyond week 4 may indicate an erythropoiesis-stimulating effect of sodium-glucose cotransporter 2 inhibition.
贫血在 2 型糖尿病（T2D）患者中很常见，尤其是在肾功能受损的患者中，且常常未被识别。达格列净治疗可增加血红蛋白和血清促红细胞生成素水平。我们研究了达格列净 10mg/天对伴或不伴贫血的 T2D 患者血红蛋白的影响。
汇总了来自 14 项安慰剂对照、达格列净治疗、至少 24 周的研究的 5325 例患者的数据。评估了达格列净（与安慰剂相比）对伴或不伴贫血的患者的血红蛋白、血清白蛋白、估算肾小球滤过率（eGFR）、收缩压、体重和安全性的影响。
基线时，所有 T2D 患者中有 13%，慢性肾脏病（eGFR <60mL/min/1.73m）患者中有 28%患有贫血。在达格列净治疗的患者中，血红蛋白持续增加，至少在第 8 周时，并在 24 周随访期间保持稳定。在达格列净治疗的患者中，血清白蛋白在第 4 周时增加，此后保持稳定。达格列净耐受性良好，可纠正基线时贫血患者的 52%（安慰剂：26%）。达格列净治疗患者新发贫血的发生率低于安慰剂治疗患者（2.3% vs. 6.5%）。
达格列净治疗可纠正和预防 T2D 患者的贫血。血红蛋白在第 4 周后持续增加可能表明钠-葡萄糖共转运蛋白 2 抑制具有促红细胞生成作用。
