Adherence in patients transferred from immediate release metformin to a sustained release formulation: a population-based study
Adherence in patients transferred from immediate release metformin to a sustained release formulation: a population-based study
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DOI：
10.1111/j.1463-1326.2008.00973.x
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发表时间：
2009-04-01
影响因子：
5.8
通讯作者：
Pearson, E. R.
中科院分区：
文献类型：
--
作者：
Donnelly, L. A.;Morris, A. D.;Pearson, E. R.
目的：二甲双胍是治疗2型糖尿病最常用的口服药物。它能有效降低糖化血红蛋白（HbA 1c），减少微血管和大血管疾病。然而，高达25%的患者出现胃肠道副作用，导致5-10%的使用者停止使用。二甲双胍XL（格华止SR）是一种每日一次的制剂，可延迟吸收，导致二甲双胍峰浓度降低。我们假设，二甲双胍的XL制剂将更好地耐受比标准的立即释放（IR）制剂，从而提高依从性therapeutic.Methods：在一项回顾性观察性研究中，我们研究了遵守和血糖控制的患者规定二甲双胍IR和XL制剂在泰赛德，英国。XL组的总体依从性（80%）高于IR组的10772例患者（72%，p = 0.0026）。在有足够数据确定依从性的40例从二甲双胍IR改为二甲双胍XL的患者中，依从性从IR组的62%增加到XL组的81%（p < 0.0001）。这与HbA 1c从9.1%降低到8.4%有关（p = 0.0739，n = 29）。结论：与IR制剂相比，Metaldehyde XL的使用与依从性增加有关，尽管本研究无法确定其机制。对于二甲双胍IR不耐受的患者，应考虑XL制剂。
Aim: Metformin is the most commonly prescribed oral agent used in the treatment of type 2 diabetes. It is effective at reducing glycosylated Haemoglobin (HbA1c) and decreasing microvascular and macrovascular disease. However, up to 25% of patients develop gastrointestinal side effects leading to cessation in 5-10% of users. Metformin XL (glucophage SR) is a once a day preparation that delays absorption, leading to decreased peak metformin concentrations. We hypothesised that the XL preparation of metformin would be better tolerated than the standard immediate release (IR) preparation leading to improved adherence to therapy.Methods: In a retrospective observational study, we studied adherence and glycaemic control in patients prescribed metformin IR and XL preparations in Tayside, UK.Results: Metformin XL was used by 137 patients during the study period. Overall adherence was greater in the XL group (80%) compared with the 10 772 patients in the IR group (72%, p = 0.0026). In the 40 patients who changed from metformin IR to metformin XL who had sufficient data to determine adherence, the adherence increased from 62% in the IR group to 81% in the XL group (p < 0.0001). This was associated with an HbA1c reduction from 9.1 to 8.4% (p = 0.0739, n = 29).Conclusions: Metformin XL use is associated with increased adherence compared with the IR preparation, although the mechanism for this cannot be determined from this study. In patients intolerant of metformin IR the XL preparation should be considered.