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メトホルミンとチアゾリジンディオンの使用は,心不全のメディケア患者で
Frederick A Masoudi1, Yongfei Wang, Silvio E Inzucchi
1Division of Cardiology, Department of Medicine, Denver Health Medical Center, Colorado, USA.
JAMA
|July 3, 2003
まとめ
心不全の糖尿病患者におけるメトホルミンとチアゾリジンダイオンの使用は,FDAの警告にもかかわらず,著しく増加しています. 患者の安全性と最適な治療戦略を確保するために,さらなる研究が必要です.
科学分野:
- 心臓病学 心臓病学
- エンドクリノロジー エンドクリノロジー
- 薬理学 薬理学とは
背景:
- メトホルミンは心不全の患者では禁忌であり,チアゾリジンダイオンは進行性心不全では推奨されません.
- 心不全の糖尿病患者のこれらの抗高血糖薬の使用パターンに関するデータは限られている.
研究 の 目的:
- 糖尿病と心不全の両方の入院患者におけるメトホルミンとチアゾリジンダイオンの処方傾向を決定する.
主な方法:
- 医療記録の抽象化による連続的断面測定を用いた.
- 1998-1999年と2000-2001年の間に心不全と糖尿病で入院した2つの国家メディケア受給者サンプルから得られたデータを分析した.
主要な成果:
- メトホルミンまたはチアゾリジンジオンを退院時に処方する割合は,1998~1999年の13.5%から2000~2001年の24.4%に増加した.
- メトホルミンの使用は7.1%から11.2%に増加し,チアゾリジンダイオンの使用は研究期間中に7.2%から16.1%に増加しました.
- この傾向は,すべての人口集団において一貫していた.
結論:
- メトホルミンとチアゾリジンダイオンの使用は,FDAの警告に反して,心臓機能不全の糖尿病患者の間で流行しており,急速に増加しています.
- この患者集団におけるこれらの薬剤の安全性と有効性を評価するために,さらなる研究が不可欠です.
- 糖尿病や心不全の患者に最適なケアを提供するためには,これらの処方パターンのさらなる調査が必要である.
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