Sitagliptin Treatment at the Time of Hospitalization Was Associated With Reduced Mortality in Patients With Type 2 Diabetes and COVID-19: A Multicenter, Case-Control, Retrospective, Observational Study.
Sitagliptin Treatment at the Time of Hospitalization Was Associated With Reduced Mortality in Patients With Type 2 Diabetes and COVID-19: A Multicenter, Case-Control, Retrospective, Observational Study.
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DOI：
10.2337/dc20-1521
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发表时间：
2020-12
期刊：
影响因子：
16.2
通讯作者：
Fiorina P
中科院分区：
文献类型：
--
作者：
Solerte SB;D'Addio F;Trevisan R;Lovati E;Rossi A;Pastore I;Dell'Acqua M;Ippolito E;Scaranna C;Bellante R;Galliani S;Dodesini AR;Lepore G;Geni F;Fiorina RM;Catena E;Corsico A;Colombo R;Mirani M;De Riva C;Oleandri SE;Abdi R;Bonventre JV;Rusconi S;Folli F;Di Sabatino A;Zuccotti G;Galli M;Fiorina P
据报道，2型糖尿病和2019冠状病毒病（COVID-19）患者的结局较差;因此，必须为这一人群探索新的治疗方法。在一项多中心、病例对照、回顾性、观察性研究中，将西格列汀（一种口服高选择性二肽基肽酶4抑制剂）添加到标准治疗中（例如，在因COVID-19住院的2型糖尿病患者住院时给予胰岛素）。每个中心还以1：1的比例招募年龄和性别匹配的未治疗对照受试者。所有患者均患有肺炎，在呼吸环境空气或接受氧气支持时，氧饱和度<95%。主要终点是出院/死亡和临床结局改善，定义为七类改良顺序量表上至少增加两个点。从2020年3月1日至4月30日接受西格列汀治疗的患者中回顾性收集数据。在本研究纳入的北方意大利医院收治的338例连续2型糖尿病和COVID-19患者中，169例接受西格列汀治疗，169例接受标准治疗。住院时接受西格列汀治疗与死亡率降低相关（18% vs. 37%的死亡患者;风险比0.44 [95% CI 0.29-0.66]; P = 0.0001），临床结局改善（60% vs. 38%的改善患者; P = 0.0001）和出院人数（120 vs. 89例出院患者; P = 0.0008）分别高于接受标准治疗的患者。在这项针对因COVID-19入院的2型糖尿病患者的多中心、病例对照、回顾性、观察性研究中，与标准治疗相比，住院时接受西格列汀治疗与死亡率降低和临床结局改善相关。西格列汀在2型糖尿病和COVID-19患者中的作用应在正在进行的随机、安慰剂对照试验中得到证实。
Poor outcomes have been reported in patients with type 2 diabetes and coronavirus disease 2019 (COVID-19); thus, it is mandatory to explore novel therapeutic approaches for this population. In a multicenter, case-control, retrospective, observational study, sitagliptin, an oral and highly selective dipeptidyl peptidase 4 inhibitor, was added to standard of care (e.g., insulin administration) at the time of hospitalization in patients with type 2 diabetes who were hospitalized with COVID-19. Every center also recruited at a 1:1 ratio untreated control subjects matched for age and sex. All patients had pneumonia and exhibited oxygen saturation <95% when breathing ambient air or when receiving oxygen support. The primary end points were discharge from the hospital/death and improvement of clinical outcomes, defined as an increase in at least two points on a seven-category modified ordinal scale. Data were collected retrospectively from patients receiving sitagliptin from 1 March through 30 April 2020. Of the 338 consecutive patients with type 2 diabetes and COVID-19 admitted in Northern Italy hospitals included in this study, 169 were on sitagliptin, while 169 were on standard of care. Treatment with sitagliptin at the time of hospitalization was associated with reduced mortality (18% vs. 37% of deceased patients; hazard ratio 0.44 [95% CI 0.29–0.66]; P = 0.0001), with an improvement in clinical outcomes (60% vs. 38% of improved patients; P = 0.0001) and with a greater number of hospital discharges (120 vs. 89 of discharged patients; P = 0.0008) compared with patients receiving standard of care, respectively. In this multicenter, case-control, retrospective, observational study of patients with type 2 diabetes admitted to the hospital for COVID-19, sitagliptin treatment at the time of hospitalization was associated with reduced mortality and improved clinical outcomes as compared with standard-of-care treatment. The effects of sitagliptin in patients with type 2 diabetes and COVID-19 should be confirmed in an ongoing randomized, placebo-controlled trial.
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