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达格列净治疗老年2型糖尿病患者的疗效和安全性分析:一项系统评价和荟萃分析

Insights into efficacy and safety of dapagliflozin treatment for the management in older adults with type 2 diabetes: a systematic review and meta-analysis.

作者信息

Jiang Lili, Jia Yanyan, Wang Xiaoyu, Wang Zhe, Lv Xin, Jia Yaqin, Feng Yuyi, Yin Hang, Yan Mingrui, Fan Xiaoyu, Liu Yong

机构信息

School of Life and Pharmaceutical Sciences, Dalian University of Technology, Panjin, Liaoning, China.

出版信息

Expert Opin Drug Saf. 2023 Jan-Jun;22(5):407-416. doi: 10.1080/14740338.2023.2166485. Epub 2023 Jan 9.

Abstract

BACKGROUND

This study aimed to evaluate the efficacy and safety of dapagliflozin as a monotherapy glucose-lowering drug treatment for older adults with diabetes.

RESEARCH DESIGN & METHODS: Randomized controlled trial reports were retrieved from PubMed, Embase Cochrane Library, and Web of Science from database inception to 8 May 2021. Publication bias and heterogeneity were assessed using the Cochrane risk-of-bias tool and the Cochrane Q statistic, respectively.

RESULTS

Compared with placebo, dapagliflozin as a monotherapy glucose-lowering drug did improve the control of glycosylated hemoglobin and fasting plasma glucose levels in older adults. Our analysis also confirmed that the body weight of older adults was well controlled under treatment of dapagliflozin as a monotherapy glucose-lowering drug. Patients in older adults with diabetes took a higher risk of genital infection and renal impairment or failure after treatment of dapagliflozin. In addition, treatment with dapagliflozin reduced the risk of hypoglycemia, and did not reveal increased risk of urinary tract infection and developing fractures compared to placebo in older adults.

CONCLUSIONS

Dapagliflozin as a monotherapy glucose-lowering drug appeared to be an effective treatment for older adults with diabetes, although it might increase risk of genital infection and renal impairment or failure.

摘要

背景

本研究旨在评估达格列净作为单药降糖治疗药物对老年糖尿病患者的疗效和安全性。

研究设计与方法

从数据库建立至2021年5月8日,检索PubMed、Embase、Cochrane图书馆和Web of Science中的随机对照试验报告。分别使用Cochrane偏倚风险工具和Cochrane Q统计量评估发表偏倚和异质性。

结果

与安慰剂相比,达格列净作为单药降糖药物确实改善了老年患者糖化血红蛋白和空腹血糖水平的控制。我们的分析还证实,达格列净作为单药降糖药物治疗时,老年患者的体重得到了良好控制。老年糖尿病患者在接受达格列净治疗后发生生殖器感染以及肾功能损害或衰竭的风险更高。此外,与安慰剂相比,达格列净治疗降低了老年患者低血糖风险,且未显示出尿路感染和骨折风险增加。

结论

达格列净作为单药降糖药物似乎是治疗老年糖尿病患者的有效药物,尽管它可能会增加生殖器感染以及肾功能损害或衰竭的风险。

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