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恩格列净治疗糖尿病肾病新使用者的药物优化

Medication Optimization for New Initiators of Empagliflozin for Diabetic Kidney Disease.

作者信息

Swanner Andrew A, Hawley Chelsea E, Li Kay, Triantafylidis Laura K, Li Jiahua, Paik Julie M

机构信息

Pharmacy Department, VA Boston Healthcare System, Boston.

New England Geriatric Research, Education and Clinical Center, VA Boston Healthcare System, Boston.

出版信息

Clin Diabetes. 2022 Spring;40(2):158-167. doi: 10.2337/cd21-0078. Epub 2022 Apr 15.

Abstract

Sodium-glucose cotransporter 2 (SGLT2) inhibitors are recommended agents for the treatment of diabetic kidney disease (DKD). Additionally, SGLT2 inhibitors lower blood glucose, decrease blood pressure, and can be useful for volume management. For these reasons, we hypothesized that initiating SGLT2 inhibitor therapy may be associated with deprescribing of other medications in patients with DKD. We compared medication lists at SGLT2 inhibitor initiation and 6 months post-initiation in 21 patients with DKD who were followed in our interprofessional outpatient nephrology clinic to evaluate deprescribing patterns in diabetes, hypertension, and diuretic medications. Six months of SGLT2 inhibitor therapy in patients with DKD was associated with deprescribing of high-risk diabetes agents, antihypertensives, and loop diuretics with minimal changes in A1C and fewer adverse events.

摘要

钠-葡萄糖协同转运蛋白2(SGLT2)抑制剂是治疗糖尿病肾病(DKD)的推荐药物。此外,SGLT2抑制剂可降低血糖、降低血压,并且有助于容量管理。基于这些原因,我们推测开始使用SGLT2抑制剂治疗可能与DKD患者停用其他药物有关。我们比较了在我们跨专业门诊肾病诊所接受随访的21例DKD患者开始使用SGLT2抑制剂时和开始治疗6个月后的用药清单,以评估糖尿病、高血压和利尿剂药物的停药模式。DKD患者接受6个月的SGLT2抑制剂治疗与停用高风险糖尿病药物、抗高血压药物和袢利尿剂有关,糖化血红蛋白(A1C)变化最小,不良事件减少。

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