Diabetes Obes Metab:钠-葡萄糖协同转运蛋白-2抑制剂致急性肾损伤

2019-05-05 xing.T 网络

虽然这些数据表明SGLT2抑制剂可以保护易受伤害的2型糖尿病患者免于AKI,并且有必要进行前瞻性研究来评估肾脏保护的这一效应。

三项观察钠-葡萄糖协同转运蛋白-2(SGLT2)抑制剂的血管结局的多中心、大规模、随机、安慰剂对照试验均显示2型糖尿病患者心力衰竭住院治疗和慢性肾脏疾病进展显著减少。然而,对于这种表面上转变的药物类别,安全问题仍然存在。特别是,FDA强调了急性肾损伤(AKI)的风险,这是一种高发病率和高死亡率的疾病。

为了进一步研究这一点,近日,代谢内分泌疾病领域权威杂志Diabetes Obesity & Metabolism上发表了一篇研究文章,研究人员对三项试验进行了荟萃分析,以比较安慰剂治疗组和接受SGLT2抑制剂治疗的患者AKI不良事件报告的频率。

研究人员注意到,随机接受SGLT2抑制剂的患者AKI可能性持续且稳健地降低(风险比为0.66,95%置信区间为0.54-0.80),而不是增加。研究人员进一步指出,AKI的报告频率与肾病进展的报告相似。

虽然这些数据表明SGLT2抑制剂可以保护易受伤害的2型糖尿病患者免于AKI,并且有必要进行前瞻性研究来评估肾脏保护的这一效应。
 
原始出处:

Richard E. Gilbert,et al.Acute Kidney Injury with sodium‐glucose linked cotransporter‐2 inhibitors: a meta‐analysis of cardiovascular outcome trials.Diabetes Obesity & Metabolism.2019.https://onlinelibrary.wiley.com/doi/10.1111/dom.13754

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    2020-02-04 jklm09
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createdBy=0045169, createdName=木头人513, createdTime=Tue Dec 24 23:54:00 CST 2019, time=2019-12-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1851985, encodeId=ad411851985ab, content=<a href='/topic/show?id=f0a254918f0' target=_blank style='color:#2F92EE;'>#抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54918, encryptionId=f0a254918f0, topicName=抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=44a360, createdName=jklm09, createdTime=Tue Feb 04 00:54:00 CST 2020, time=2020-02-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1995560, encodeId=6c431995560b2, content=<a href='/topic/show?id=992411149e' target=_blank style='color:#2F92EE;'>#2抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1114, encryptionId=992411149e, topicName=2抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=28b7142, createdName=liuquan, createdTime=Fri Oct 11 22:54:00 CST 2019, time=2019-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1888012, encodeId=c461188801286, content=<a href='/topic/show?id=d56611584ec' target=_blank style='color:#2F92EE;'>#Meta#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11584, encryptionId=d56611584ec, topicName=Meta)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d8f4110, createdName=guojianrong, createdTime=Sun Aug 11 06:54:00 CST 2019, time=2019-08-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1761099, encodeId=03fd1e61099e3, content=<a href='/topic/show?id=9bea33520d' target=_blank style='color:#2F92EE;'>#BET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3352, encryptionId=9bea33520d, topicName=BET)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9a1a37427546, createdName=ms5439512287675881, createdTime=Wed Dec 18 19:54:00 CST 2019, time=2019-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1696337, encodeId=3a3c169633ea3, content=<a href='/topic/show?id=0107934e0a5' target=_blank style='color:#2F92EE;'>#转运#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93470, encryptionId=0107934e0a5, topicName=转运)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=47c429881595, createdName=yzh409, createdTime=Tue Jun 11 23:54:00 CST 2019, time=2019-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1691564, encodeId=ac2016915642e, content=<a 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time=2019-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1397755, encodeId=353f139e755b1, content=<a href='/topic/show?id=8bee565436d' target=_blank style='color:#2F92EE;'>#损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56543, encryptionId=8bee565436d, topicName=损伤)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eoNX3lUOlDKGBUEPNwZx0nibmdcFyeibnX4WMhUSCU2REpGRWtSmnT2CCs0dA5waxvJknYDxwtYnIcQ/132, createdBy=294e2500218, createdName=ms3046638856685384, createdTime=Tue May 07 03:54:00 CST 2019, time=2019-05-07, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1639091, encodeId=4a961639091f9, content=<a href='/topic/show?id=afda591646' target=_blank style='color:#2F92EE;'>#DIA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5916, encryptionId=afda591646, topicName=DIA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=987022654425, createdName=ms9608593228839890, createdTime=Wed Feb 26 04:54:00 CST 2020, time=2020-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1902248, encodeId=b6051902248f4, content=<a href='/topic/show?id=c097591ed5' target=_blank style='color:#2F92EE;'>#Diabetes#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5917, encryptionId=c097591ed5, topicName=Diabetes)], attachment=null, authenticateStatus=null, createdAvatar=, 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encryptionId=992411149e, topicName=2抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=28b7142, createdName=liuquan, createdTime=Fri Oct 11 22:54:00 CST 2019, time=2019-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1888012, encodeId=c461188801286, content=<a href='/topic/show?id=d56611584ec' target=_blank style='color:#2F92EE;'>#Meta#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11584, encryptionId=d56611584ec, topicName=Meta)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d8f4110, createdName=guojianrong, createdTime=Sun Aug 11 06:54:00 CST 2019, time=2019-08-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1761099, encodeId=03fd1e61099e3, content=<a href='/topic/show?id=9bea33520d' target=_blank style='color:#2F92EE;'>#BET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3352, encryptionId=9bea33520d, topicName=BET)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9a1a37427546, createdName=ms5439512287675881, createdTime=Wed Dec 18 19:54:00 CST 2019, time=2019-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1696337, encodeId=3a3c169633ea3, content=<a href='/topic/show?id=0107934e0a5' target=_blank style='color:#2F92EE;'>#转运#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93470, encryptionId=0107934e0a5, topicName=转运)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=47c429881595, createdName=yzh409, createdTime=Tue Jun 11 23:54:00 CST 2019, time=2019-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1691564, encodeId=ac2016915642e, content=<a href='/topic/show?id=d3349643968' target=_blank style='color:#2F92EE;'>#钠-葡萄糖协同转运蛋白-2抑制剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96439, encryptionId=d3349643968, topicName=钠-葡萄糖协同转运蛋白-2抑制剂)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5c9529239665, createdName=jklm19, createdTime=Tue Aug 27 10:54:00 CST 2019, time=2019-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1896488, encodeId=e18e189648848, content=<a href='/topic/show?id=4a391158248' target=_blank style='color:#2F92EE;'>#MET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11582, encryptionId=4a391158248, topicName=MET)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18fc139, createdName=一闲, createdTime=Fri May 24 17:54:00 CST 2019, time=2019-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1397755, encodeId=353f139e755b1, content=<a href='/topic/show?id=8bee565436d' target=_blank style='color:#2F92EE;'>#损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56543, encryptionId=8bee565436d, topicName=损伤)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eoNX3lUOlDKGBUEPNwZx0nibmdcFyeibnX4WMhUSCU2REpGRWtSmnT2CCs0dA5waxvJknYDxwtYnIcQ/132, createdBy=294e2500218, createdName=ms3046638856685384, createdTime=Tue May 07 03:54:00 CST 2019, time=2019-05-07, status=1, ipAttribution=)]
    2019-08-11 guojianrong
  6. 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  7. 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time=2019-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1397755, encodeId=353f139e755b1, content=<a href='/topic/show?id=8bee565436d' target=_blank style='color:#2F92EE;'>#损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56543, encryptionId=8bee565436d, topicName=损伤)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eoNX3lUOlDKGBUEPNwZx0nibmdcFyeibnX4WMhUSCU2REpGRWtSmnT2CCs0dA5waxvJknYDxwtYnIcQ/132, createdBy=294e2500218, createdName=ms3046638856685384, createdTime=Tue May 07 03:54:00 CST 2019, time=2019-05-07, status=1, ipAttribution=)]
    2019-06-11 yzh409
  8. 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  9. 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time=2019-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1397755, encodeId=353f139e755b1, content=<a href='/topic/show?id=8bee565436d' target=_blank style='color:#2F92EE;'>#损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56543, encryptionId=8bee565436d, topicName=损伤)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eoNX3lUOlDKGBUEPNwZx0nibmdcFyeibnX4WMhUSCU2REpGRWtSmnT2CCs0dA5waxvJknYDxwtYnIcQ/132, createdBy=294e2500218, createdName=ms3046638856685384, createdTime=Tue May 07 03:54:00 CST 2019, time=2019-05-07, status=1, ipAttribution=)]
    2019-05-24 一闲
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SGLT2抑制剂可增加糖尿病酮酸症的患病风险,应该在医生开药时纳入考虑,特别时当病人已经表现出糖尿病酮酸症时。

观察性研究中使用SGLT2抑制剂死亡风险较低:真实还是偏倚?

最近的两项观察性研究报道,钠 -葡萄糖协同转运蛋白-2抑制剂(sodium–glucoseco transporter 2 inhibitor, SGLT2i)对于心血管疾病风险增加的人群以及所有2型糖尿病患者,均能显著降低全因死亡率。在这两项研究中,全因死亡率降低50% 以上,种降低幅度均明显大于2型糖尿病BI10773(恩格列净)心血管终点事件试验(BI 10773 [Empagliflo

SCI REP:SGLT2抑制剂对2型糖尿病患者尿路感染和生殖系感染的影响!

即将到来的重大研究可能提供对尿路感染额外的重要见解,并且需要更多的努力以解决每个服用SGLT2抑制剂的个体对感染的比较效应。

美国FDA拒绝了双重SGLT1和SGLT2抑制剂Zynquista治疗1型糖尿病的申请

赛诺菲和Lexicon制药公司周五(2019年3月23日)宣布,FDA已拒绝其双重SGLT1和SGLT2抑制剂Zynquista(sotagliflozin)合并胰岛素用于治疗成人1型糖尿病的申请。

Diabetes Obes Metab:SGLT2抑制剂对2型糖尿病和慢性肾病患者的心血管、肾脏和安全性结局的影响

目前可获得的数据表明,尽管糖化血红蛋白仅有适度减少,但SGLT2抑制剂可降低T2DM和CKD患者心血管和肾脏结局的风险,但没有明确证据表明存在额外的安全性问题。

Lancet:SGLT2抑制剂对II型糖尿病患者心血管及肾功能的影响研究

研究认为SGLT2抑制剂可中等程度地降低II型糖尿病伴动脉粥样硬化患者主要心血管不良事件风险,同时可显著降低所有患者的心力衰竭和肾脏疾病进展风险