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亚洲 2 型糖尿病患者使用磺脲类药物的真实世界数据:联合亚洲糖尿病评估(JADE)注册研究。

Real-world usage of sulphonylureas in Asian patients with type 2 diabetes using the Joint Asia Diabetes Evaluation (JADE) register.

机构信息

Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.

Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, China.

出版信息

Diabetes Obes Metab. 2023 Jan;25(1):208-221. doi: 10.1111/dom.14865. Epub 2022 Sep 26.

Abstract

AIMS

To explore the patterns of use of oral glucose-lowering drugs (OGLDs) in Asian patients with type 2 diabetes (T2D), focusing on sulphonylureas (SUs), and to describe patient profiles according to treatment regimen.

METHODS

We conducted a cross-sectional analysis of data from adults with T2D from 11 Asian countries/regions with structured assessment enrolled in the prospective Joint Asia Diabetes Evaluation (JADE) register between November 2007 and December 2019. Patients receiving insulin and/or injectable glucagon-like peptide-1 receptor agonists were excluded.

RESULTS

Amongst 62 512 patients (mean ± standard deviation age: 57.3 ± 11.8 years; 53.6% men), 54 783 (87.6%) were treated with OGLDs at enrolment. Most received one (37.5%) or two (44.2%) OGLDs. In the entire cohort, 59.4% of treated patients received SU-based therapy with variations amongst countries/regions. Overall, 79.5% of SU regimens were based on SUs plus metformin, and 22.1% on SUs plus dipeptidyl peptidase-4 inhibitors. Among SU users, gliclazide was most commonly prescribed (46.7%), followed by glimepiride (40.0%) and glibenclamide (8.1%). More gliclazide users entered the cohort with glycated haemoglobin levels <53 mmol/mol (7%) than non-gliclazide SU users (odds ratio [OR] 1.09, 95% CI 1.02-1.17), with less frequent self-reported hypoglycaemia in the 3 months before registration (OR 0.81, 95% CI 0.72-0.92; adjusted for sociodemographic factors, cardiometabolic risk factors, complications, use of other OGLDs, country/region and year of registration).

CONCLUSION

In Asia, SUs are a popular OGLD class, often combined with metformin. Good glycaemic control and safety profiles associated with the use of SUs, including gliclazide, support their position as a key treatment option in patients with T2D.

摘要

目的

探讨亚洲 2 型糖尿病(T2D)患者口服降糖药物(OGLD)的使用模式,重点关注磺酰脲类药物(SUs),并根据治疗方案描述患者特征。

方法

我们对 2007 年 11 月至 2019 年 12 月期间参加前瞻性联合亚洲糖尿病评估(JADE)登记的 11 个亚洲国家/地区的成年 T2D 患者进行了一项横断面数据分析。排除接受胰岛素和/或胰高血糖素样肽-1 受体激动剂治疗的患者。

结果

在 62512 名患者中(平均年龄±标准差:57.3±11.8 岁;53.6%为男性),54783 名(87.6%)在入组时接受 OGLD 治疗。大多数患者接受一种(37.5%)或两种(44.2%)OGLD。在整个队列中,接受治疗的患者中有 59.4%接受 SU 为基础的治疗,不同国家/地区之间存在差异。总体而言,79.5%的 SU 方案基于 SU 加二甲双胍,22.1%基于 SU 加二肽基肽酶-4 抑制剂。在 SU 使用者中,格列齐特最常被开处方(46.7%),其次是格列美脲(40.0%)和格列本脲(8.1%)。与非格列齐特 SU 使用者相比,进入队列时糖化血红蛋白水平<53mmol/mol(7%)的格列齐特使用者更多(比值比[OR]1.09,95%置信区间[CI]1.02-1.17),登记前 3 个月报告的低血糖事件频率更低(OR 0.81,95%CI 0.72-0.92;调整社会人口学因素、心血管代谢危险因素、并发症、其他 OGLD 的使用、登记的国家/地区和年份)。

结论

在亚洲,SU 是一种流行的 OGLD 类别,通常与二甲双胍联合使用。SU 包括格列齐特在内的良好血糖控制和安全性特征支持其作为 T2D 患者关键治疗选择的地位。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/076e/10087907/f9202385831e/DOM-25-208-g002.jpg

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