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索格列净,一种双重钠-葡萄糖共转运蛋白 1 和钠-葡萄糖共转运蛋白 2 抑制剂,通过 Steno T1 Risk Engine 在 1 型糖尿病成人中评估,降低了心血管和肾脏疾病的风险。

Sotagliflozin, a dual sodium-glucose co-transporter-1 and sodium-glucose co-transporter-2 inhibitor, reduces the risk of cardiovascular and kidney disease, as assessed by the Steno T1 Risk Engine in adults with type 1 diabetes.

机构信息

Complication Research, Steno Diabetes Center Copenhagen, Herlev, Denmark.

Department of Clinical Medicine, University of Copenhagen, Herlev, Denmark.

出版信息

Diabetes Obes Metab. 2023 Jul;25(7):1874-1882. doi: 10.1111/dom.15047. Epub 2023 Mar 20.

Abstract

AIMS

Sotagliflozin (SOTA) as adjunct to insulin therapy improves glycemic control, reduces body weight and blood pressure, and increases time in range in adults with type 1 diabetes (T1D). SOTA demonstrated CV and kidney benefits in high-risk adults with type 2 diabetes. These potential benefits using SOTA for T1D may collectively outweigh the risk of diabetic ketoacidosis. The present analysis estimated the risk of CVD and kidney failure in adults with T1D treated with SOTA.

MATERIALS AND METHODS

Participant-level data were used from the inTandem trials evaluating 2980 adults with T1D randomized to once-daily placebo, SOTA 200 mg, or SOTA 400 mg for 24 weeks. For each participant, the cumulative risks of developing CVD and kidney failure were estimated using the Steno T1 Risk Engine. A subgroup analysis was performed in participants with BMI ≥ 27 kg/m .

RESULTS

SOTA significantly reduced the predicted 5- and 10-year CVD risk in the SOTA 200 and 400 mg pooled group with a relative change in the SOTA group compared to the relative change in the placebo group of (mean [95%-confidence interval (CI)]) -6.6 (-7.9, -5.3) % and -6.4 (-7.6, -5.1) % (p < 0.0001 for both) respectively. For the 5-year ESKD risk there was a significant reduction with a relative change of -5.0 (-7.6, -2.3) % (p = 0.0003). Similar results were observed with the individual doses and in participants with BMI ≥ 27 kg/m .

CONCLUSION

This analysis provides additional clinical results that may positively balance the benefit/risk assessment of SGLT inhibition use in T1D.

摘要

目的

索格列净(SOTA)作为胰岛素治疗的辅助药物,可改善 1 型糖尿病(T1D)成人的血糖控制,减轻体重和血压,并增加达标时间。SOTA 在伴有高风险的 2 型糖尿病成人中表现出心血管和肾脏获益。在 T1D 中使用 SOTA 的这些潜在获益可能总体上超过糖尿病酮症酸中毒的风险。本分析旨在评估 T1D 成人使用 SOTA 治疗的心血管疾病(CVD)和肾衰竭风险。

材料和方法

使用来自 inTandem 试验的参与者水平数据,该试验评估了 2980 名 T1D 成人,他们随机接受每日一次安慰剂、SOTA 200mg 或 SOTA 400mg 治疗 24 周。对于每个参与者,使用 Steno T1 风险引擎估计发生 CVD 和肾衰竭的累积风险。在 BMI≥27kg/m 的参与者中进行了亚组分析。

结果

SOTA 显著降低了 SOTA 200mg 和 400mg 联合治疗组预测的 5 年和 10 年 CVD 风险,与安慰剂组相比,SOTA 组的相对变化为(平均值[95%-置信区间(CI)])-6.6(-7.9,-5.3)%和-6.4(-7.6,-5.1)%(p均<0.0001)。对于 5 年估算的终末期肾病(ESKD)风险,相对变化为-5.0(-7.6,-2.3)%,有显著降低(p=0.0003)。在个体剂量和 BMI≥27kg/m 的参与者中也观察到类似的结果。

结论

这项分析提供了额外的临床结果,可能会对 T1D 中 SGLT 抑制使用的获益/风险评估产生积极影响。

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