Tian Chunyan, Yang Zheng, Zhao Subei, Zhang Ping, Li Rong
Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Nutr Metab Cardiovasc Dis. 2025 Jan;35(1):103758. doi: 10.1016/j.numecd.2024.09.028. Epub 2024 Sep 27.
We evaluate whether the combination of sodium-glucose cotransporter-2 inhibitor(SGLT2i) and glucagon-like peptide-1 receptor agonist(GLP1RA) disproportionally increases the reporting of adverse events compared with SGLT2i or GLP1RA monotherapy in the FDA adverse event reporting system (FAERS).
Adverse events related to SGLT2i and GLP1RA were screened and selected, then data from the FAERS was underwent thorough disproportionality analysis. The proportional reporting ratio(PRR) of SGLT2i-related adverse events were compared between patients using SGLT2i alone and those using both SGLT2i and GLP1RA. Similarly, the PRR of GLP1RA-related adverse events were compared between patients using GLP1RA alone and those using both SGLT2i and GLP1RA. The results showed that the PRR of SGLT2i-related adverse events including diabetic ketoacidosis(DKA), ketosis, reproductive tract adverse events, urinary tract infection, and other adverse events, decreased in individuals using both SGLT2i and GLP1RA compared with those using SGLT2i alone, and the signal of fracture was not detected. Likewise, the PRR of GLP1RA-related adverse events including gastrointestinal adverse events, gallbladder and biliary tract disease, pancreatitis, and other adverse events, decreased in individuals using both SGLT2i and GLP1RA compared with those using GLP1RA alone, the PRR of hyperlipasaemia and hyperamylasaemia increased in the combination therapy and no signal of depression, suicidal and self-injurious behaviour was detected.
Adverse events reporting are not disproportionally higher among those using both SGLT-2i and GLP1RA compared with SGLT2i or GLP1RA monotherapy.
我们评估在食品药品监督管理局不良事件报告系统(FAERS)中,与钠-葡萄糖协同转运蛋白2抑制剂(SGLT2i)或胰高血糖素样肽-1受体激动剂(GLP1RA)单药治疗相比,SGLT2i与GLP1RA联合使用是否会不成比例地增加不良事件的报告率。
筛选并选择与SGLT2i和GLP1RA相关的不良事件,然后对FAERS的数据进行全面的不成比例性分析。比较单独使用SGLT2i的患者与同时使用SGLT2i和GLP1RA的患者中SGLT2i相关不良事件的比例报告率(PRR)。同样,比较单独使用GLP1RA的患者与同时使用SGLT2i和GLP1RA的患者中GLP1RA相关不良事件的PRR。结果显示,与单独使用SGLT2i的个体相比,同时使用SGLT2i和GLP1RA的个体中,包括糖尿病酮症酸中毒(DKA)、酮症、生殖道不良事件、尿路感染和其他不良事件在内的SGLT2i相关不良事件的PRR降低,且未检测到骨折信号。同样,与单独使用GLP1RA的个体相比,同时使用SGLT2i和GLP1RA的个体中,包括胃肠道不良事件、胆囊和胆道疾病、胰腺炎及其他不良事件在内的GLP1RA相关不良事件的PRR降低,联合治疗中高脂血症和高淀粉酶血症的PRR升高,且未检测到抑郁、自杀和自伤行为信号。
与SGLT2i或GLP1RA单药治疗相比,同时使用SGLT-2i和GLP1RA的患者不良事件报告率并未不成比例地更高。