Systematic review of SGLT2 receptor inhibitors in dual or triple therapy in type 2 diabetes.
Systematic review of SGLT2 receptor inhibitors in dual or triple therapy in type 2 diabetes.
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DOI：
10.1136/bmjopen-2012-001007
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发表时间：
2012
期刊：
影响因子：
2.9
通讯作者：
Waugh N
中科院分区：
文献类型：
--
作者：
Clar C;Gill JA;Court R;Waugh N
尽管2型糖尿病的药物数量很多，但许多患有这种疾病的人并没有达到良好的血糖控制。一些现有的降糖药物具有不良反应，如体重增加或低血糖。2型糖尿病往往是一种进行性疾病，大多数患者需要联合降糖药物治疗。钠葡萄糖协同转运蛋白2（SGLT 2）受体抑制剂是一类新型降糖药物。评估SGLT 2受体抑制剂在2型糖尿病双联或三联治疗中的临床有效性和安全性。MEDLINE、Embase、科克伦图书馆（所有部分）;科学引文索引;试验登记;会议摘要;药品监管机构;检索论文的参考书目。SGLT 2受体抑制剂与安慰剂或活性对照药物在2型糖尿病双联或联合治疗中的比较的随机对照试验。系统评价。质量评估采用科克伦偏倚风险评分。完整发表的7项试验评估了达格列净，1项评估了卡格列净。试验质量似乎良好。与安慰剂相比，达格列净10 mg使HbA 1c降低了−0.54%（加权平均差异（WMD），95% CI −0.67至−0.40），但与格列吡嗪相比无差异。卡格列净降低HbA 1c的幅度略大于西格列汀（与西格列汀相比，达−0.21%）。达格列净和卡格列净均导致体重减轻（与安慰剂相比，达格列净WMD为−1.81 kg（95% CI为−2.04至−1.57），卡格列净高达−2.3 kg）。 长期试验扩展表明，随着时间的推移，效果得以维持。卡格列净的数据目前仅来自一篇论文。药物的成本未知，因此无法评估成本效益。需要更多关于安全性的数据，食品和药物管理局对乳腺癌和膀胱癌表示担忧。达格列净似乎有效降低2型糖尿病患者的HbA 1c和体重，但需要更多的安全性数据。
Despite the number of medications for type 2 diabetes, many people with the condition do not achieve good glycaemic control. Some existing glucose-lowering agents have adverse effects such as weight gain or hypoglycaemia. Type 2 diabetes tends to be a progressive disease, and most patients require treatment with combinations of glucose-lowering agents. The sodium glucose co-transporter 2 (SGLT2) receptor inhibitors are a new class of glucose-lowering agents. To assess the clinical effectiveness and safety of the SGLT2 receptor inhibitors in dual or triple therapy in type 2 diabetes. MEDLINE, Embase, Cochrane Library (all sections); Science Citation Index; trial registries; conference abstracts; drug regulatory authorities; bibliographies of retrieved papers. Randomised controlled trials of SGLT2 receptor inhibitors compared with placebo or active comparator in type 2 diabetes in dual or combination therapy. Systematic review. Quality assessment used the Cochrane risk of bias score. Seven trials, published in full, assessed dapagliflozin and one assessed canagliflozin. Trial quality appeared good. Dapagliflozin 10 mg reduced HbA1c by −0.54% (weighted mean differences (WMD), 95% CI −0.67 to −0.40) compared to placebo, but there was no difference compared to glipizide. Canagliflozin reduced HbA1c slightly more than sitagliptin (up to −0.21% vs sitagliptin). Both dapagliflozin and canagliflozin led to weight loss (dapagliflozin WMD −1.81 kg (95% CI −2.04 to −1.57), canagliflozin up to −2.3 kg compared to placebo). Long-term trial extensions suggested that effects were maintained over time. Data on canagliflozin are currently available from only one paper. Costs of the drugs are not known so cost-effectiveness cannot be assessed. More data on safety are needed, with the Food and Drug Administration having concerns about breast and bladder cancers. Dapagliflozin appears effective in reducing HbA1c and weight in type 2 diabetes, although more safety data are needed.
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影响因子：
5.8
作者：
Bolinder, Jan;Ljunggren, Osten;Parikh, Shamik
通讯作者：
Parikh, Shamik
影响因子：
120.7
作者：
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DOI：
10.1097/01.asn.0000092790.89332.d2
发表时间：
2003-11-01
影响因子：
13.6
作者：
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通讯作者：
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