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在常规治疗控制不佳的 2 型糖尿病患者中不同时期使用恩格列净的安全性:一项随机对照试验的荟萃分析。

Safety of Ertugliflozin in Patients with Type 2 Diabetes Mellitus Inadequately Controlled with Conventional Therapy at Different Periods: A Meta-Analysis of Randomized Controlled Trials.

机构信息

Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.

出版信息

J Diabetes Res. 2020 Dec 14;2020:9704659. doi: 10.1155/2020/9704659. eCollection 2020.

Abstract

AIMS

To assess the safety of ertugliflozin in patients with type 2 diabetes mellitus (T2DM) inadequately controlled with conventional therapy at different periods.

METHODS

We searched PubMed, Embase, and The Cochrane Library from inception to September 23, 2020. A total of six studies involving 4120 patients were included.

RESULTS

Compared with the control group, 15 mg and 5 mg of ertugliflozin were associated with higher risks of genital mycotic infections (GMIs) at 26 weeks ( < 0.0001 and < 0.0001, respectively), 52 weeks ( < 0.00001 and < 0.0001, respectively), and 104 weeks ( < 0.00001 and < 0.0001, respectively). Moreover, females had a higher risk of GMIs than males in the 15 mg group at 26 weeks ( = 0.0008), 52 weeks ( < 0.0001), and 104 weeks ( = 0.02). At 104 weeks, 15 mg and 5 mg of ertugliflozin showed beneficial effects on symptomatic hypoglycemia ( < 0.00001 and = 0.004, respectively) compared with the effects observed in the control group. Compared with the control group, 15 mg and 5 mg of ertugliflozin were associated with higher risks of drug-related adverse events at 26 weeks ( = 0.002 and = 0.002, respectively); 15 mg of ertugliflozin was associated with a higher risk of discontinuation related to adverse events at 104 weeks ( = 0.03). No significant differences were found in the remaining safety outcomes.

CONCLUSION

This meta-analysis of randomized controlled trials indicates that ertugliflozin is tolerated by T2DM, but the risk of GMIs is noteworthy, especially among females in the high-dose group.

摘要

目的

评估依格列净在常规治疗控制不佳的 2 型糖尿病(T2DM)患者不同时期的安全性。

方法

我们检索了 PubMed、Embase 和 The Cochrane Library,检索时间截至 2020 年 9 月 23 日。共纳入 6 项研究,涉及 4120 例患者。

结果

与对照组相比,15mg 和 5mg 依格列净在 26 周(<0.0001 和<0.0001)、52 周(<0.00001 和<0.0001)和 104 周(<0.00001 和<0.0001)时,生殖道真菌感染(GMIs)风险更高。此外,在 15mg 组中,女性 GMIs 风险高于男性,在 26 周(=0.0008)、52 周(<0.0001)和 104 周(=0.02)时。在 104 周时,与对照组相比,15mg 和 5mg 依格列净对有症状的低血糖(<0.00001 和=0.004)的有益作用。与对照组相比,在 26 周时(=0.002 和=0.002),15mg 和 5mg 依格列净与药物相关不良事件的风险增加相关;在 104 周时,15mg 依格列净与因不良事件停药的风险增加相关(=0.03)。在其余安全性结局中未发现显著差异。

结论

这项随机对照试验的荟萃分析表明,依格列净可耐受 T2DM,但 GMIs 的风险值得关注,尤其是高剂量组中的女性。

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