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伊格列净对日本2型糖尿病患者长期安全性和有效性的真实世界证据:一项3年上市后监测研究(STELLA-LONG TERM)的最终结果

Real-World Evidence for Long-Term Safety and Effectiveness of Ipragliflozin in Japanese Patients with Type 2 Diabetes Mellitus: final Results of a 3-Year Post-Marketing Surveillance Study (STELLA-LONG TERM).

作者信息

Nakamura Ichiro, Maegawa Hiroshi, Tobe Kazuyuki, Uno Satoshi

机构信息

Operational Excellence, Medical Affairs Japan, Astellas Pharma Inc ., Tokyo, Japan.

Department of Medicine, Shiga University of Medical Science , Shiga, Japan.

出版信息

Expert Opin Pharmacother. 2021 Feb;22(3):373-387. doi: 10.1080/14656566.2020.1817388. Epub 2020 Oct 3.

DOI:10.1080/14656566.2020.1817388
PMID:33012212
Abstract

OBJECTIVE

To evaluate the long-term safety and effectiveness of ipragliflozin in real-world clinical practice in Japanese patients with type 2 diabetes mellitus (T2DM).

RESEARCH DESIGN AND METHODS

This post-marketing surveillance study (STELLA-LONG TERM) included Japanese patients newly initiated on ipragliflozin between 17 July 2014 and 16 October 2015 (data lock: 30 September 2019). Survey items included demographics, treatments, adverse drug reactions (ADRs), vital signs, and laboratory variables.

RESULTS

Of 11,424 registered patients, safety and efficacy analysis sets comprised of 11,051 and 8,763 patients, respectively. ADRs occurred in 2,129 patients (19.27%) and serious ADRs occurred in 210 patients (1.90%). Renal and urinary disorders (n = 739, 6.69%), particularly polyuria/pollakiuria (n = 612, 5.54%) and volume depletion-events, including dehydration (n = 243, 2.20%), comprised the most common ADRs. Mean (SD) change in hemoglobin A1c (─0.66 [1.25] %), fasting plasma glucose (─28.8 [50.1] mg/dL) and body weight (─3.33 [4.32] kg) from baseline to 36 months were statistically significant ( < 0.001).

CONCLUSIONS

The safety profile of long-term ipragliflozin treatment in routine clinical practice is consistent with previously reported interim data at 12 or 24 months and pre-approval clinical trials. Ipragliflozin treatment was also associated with sustained improvements in efficacy parameters for over 3 years.

摘要

目的

评估依帕列净在日本2型糖尿病(T2DM)患者的实际临床实践中的长期安全性和有效性。

研究设计与方法

这项上市后监测研究(STELLA-LONG TERM)纳入了2014年7月17日至2015年10月16日期间新开始使用依帕列净的日本患者(数据锁定:2019年9月30日)。调查项目包括人口统计学、治疗情况、药物不良反应(ADR)、生命体征和实验室指标。

结果

在11424名登记患者中,安全性分析集和有效性分析集分别包括11051名和8763名患者。2129名患者(19.27%)发生了药物不良反应,210名患者(1.90%)发生了严重药物不良反应。肾脏和泌尿系统疾病(n = 739,6.69%),尤其是多尿/尿频(n = 612,5.54%)和容量减少事件,包括脱水(n = 243,2.20%),是最常见的药物不良反应。从基线到36个月,糖化血红蛋白(─0.66 [1.25] %)、空腹血糖(─28.8 [50.1] mg/dL)和体重(─3.33 [4.32] kg)的平均(标准差)变化具有统计学意义(< 0.001)。

结论

在常规临床实践中,依帕列净长期治疗的安全性与之前报告的12个月或24个月的中期数据以及批准前的临床试验一致。依帕列净治疗还与超过3年的疗效参数持续改善相关。

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