Risk of Hypoglycemia After Concomitant Use of Antidiabetic, Antihypertensive, and Antihyperlipidemic Medications: A Database Study
Risk of Hypoglycemia After Concomitant Use of Antidiabetic, Antihypertensive, and Antihyperlipidemic Medications: A Database Study
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DOI：
10.1002/jcph.1147
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发表时间：
2018-10-01
影响因子：
2.9
通讯作者：
Gosho, Masahiko
中科院分区：
文献类型：
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作者：
Gosho, Masahiko
低血糖是抗糖尿病药物最重要的并发症。大多数糖尿病患者服用多种药物。在这项研究中，我们通过分析日本药物不良事件报告（JADER）数据库，探讨了导致低血糖的临床药物相互作用。主要结局为低血糖报告。Noren和Gosho方法定量测量了2种药物联合使用时观察到的不良事件数量与预期不良事件数量之间的差异，用作检测药物相互作用的标准。JADER数据库包含468292条记录的患者特征、2973172条记录的药物信息和741016条记录的不良反应。我们注意到6208例患者报告了低血糖。使用2项药物相互作用标准，观察到伴随使用利格列汀/格列本脲、西格列汀/格列本脲、西格列汀/丁格列汀、艾塞那肽/伏格列波糖、米格列奈/培哚普利、瑞格列奈/巴尼地平、阿格列汀/西尼地平、替尼格列汀/巴尼地平、替尼格列汀/乌拉地尔、艾塞那肽/坎地沙坦、伏格列波糖/巴尼地平、伏格列波糖/胍那苄或艾塞那肽/生育酚。伴随使用替尼格列净和巴尼地平产生了2项标准的最高值。替尼格列净/乌拉地尔和艾塞那肽/坎地沙坦联合给药分别观察到第二和第三高值。使用美国食品药品监督管理局不良事件报告系统数据库进行了相同的分析，以评估JADER数据库结果的有效性。在JADER和美国食品药品监督管理局不良事件报告系统数据库中均检测到合并使用西格列汀/布格列汀、艾塞那肽/伏格列波糖、瑞格列奈/巴尼地平、替尼格列汀/巴尼地平、替尼格列汀/乌拉地尔、艾塞那肽/坎地沙坦、伏格列波糖/巴尼地平、伏格列波糖/胍那苄或艾塞那肽/生育酚。与上述药物的联合治疗显示出可能导致糖尿病患者低血糖的潜在相互作用。
Hypoglycemia is the most important complication of antidiabetic medications. Most patients with diabetes mellitus take multiple medications. In this study, we explored clinical drug-drug interactions that result in hypoglycemia by analyzing the Japanese Adverse Drug Event Report (JADER) database. The primary outcome was the report of hypoglycemia. The Noren and Gosho methods, which quantitatively measure the discrepancy between the observed and expected number of adverse events under the combination of 2 drugs, were used as the criteria for detecting drug-drug interactions. The JADER database contained patient characteristics with 468292 records, drug information with 2973172 records, and adverse reactions with 741016 records. We noted that hypoglycemia was reported in 6208 patients. Concomitant use of linagliptin/glibenclamide, sitagliptin/glibenclamide, sitagliptin/buformin, exenatide/voglibose, mitiglinide/perindopril, repaglinide/barnidipine, alogliptin/cilnidipine, teneligliptin/barnidipine, teneligliptin/urapidil, exenatide/candesartan, voglibose/barnidipine, voglibose/guanabenz, or exenatide/tocopherol was noted using the 2 criteria for drug-drug interactions. Concomitant use of teneligliptin and barnidipine produced the highest values for the 2 criteria. The second-and third-highest values were observed for teneligliptin/urapidil and exenatide/candesartan combinations, respectively. The same analysis was performed using the US Food and Drug Administration Adverse Event Reporting System database to assess the validity of the result from the JADER database. The concomitant use of sitagliptin/buformin, exenatide/voglibose, repaglinide/barnidipine, teneligliptin/barnidipine, teneligliptin/urapidil, exenatide/candesartan, voglibose/barnidipine, voglibose/guanabenz, or exenatide/tocopherol was detected in both the JADER and Food and Drug Administration Adverse Event Reporting System databases. Combination therapy with the drugs listed above would show potential interactions that could result in hypoglycemia in patients with diabetes mellitus.