2型糖尿病および慢性心不全の患者におけるSGLT2阻害とループ利尿剤の併用による腎臓および心血管効果: RECEDE- CHF試験
Natalie A Mordi1, Ify R Mordi1, Jagdeep S Singh2
1Division of Molecular and Clinical Medicine, University of Dundee, Scotland, United Kingdom (N.A.M., I.R.M., R.J.M., A.D.S., C.C.L.).
Circulation
|September 1, 2020
まとめ
エムパグリフロジンなどのナトリウム・グルコース・コトランスポーター-2 (SGLT2) 阻害剤は,2型糖尿病および心不全の患者で,ループ尿薬と併用すると尿量を増加させる. この併用療法では,ナトリウム排出が増加することなく,利尿効果を高めます.
科学分野:
- 心臓病科
- 内分泌学
- 薬理学について
背景:
- 2型糖尿病患者における心不全のアウトカムには,ナトリウム・グルコース・コトランスポーター-2 (SGLT2) 阻害剤が有益である.
- SGLT2阻害剤とループ利尿薬の併用は,心不全の治療において一般的です.
- この組み合わせの利尿剤と利尿剤の効果は十分に確立されていません.
研究 の 目的:
- エムパグリフロジンとループの利尿剤を併用した時の利尿剤および利尿剤の効果を評価する.
- 2型糖尿病および心不全の患者におけるこの併用療法の安全性と有効性を評価する.
主な方法:
- RECEDE- CHF試験はランダム化,ダブルブラインド,プラセボ対照のクロスオーバー試験でした.
- 2型糖尿病と心不全の被験者は,エペクション分子が低下した状態で,エンパグリフロジン25 mgまたはプラセボを6週間投与された.
- 測定された主なアウトカムは,出血から第6週までの24時間の尿量の変化でした.
主要な成果:
- プラセボと比較して,Empagliflozinは,第3日と第6週の両方で24時間の尿量を有意に増加させた.
- エムパグリフロジンを使用した24時間の尿中のナトリウム分泌の有意な変化は観察されなかった.
- エンパグリフロジンは,電解質フリー水分クリアランスの有意な増加,体重の減少,血清尿酸の低下をもたらした.
結論:
- エムパグリフロジンは,循環性尿薬と併用すると,心不全患者の尿量を増加させる.
- この組み合わせはナトリウムの排泄を増加させないため,利便な利尿作用を示す.
- エムパグリフロジンは,体重減少と血清ウラート濃度の低下を含む追加の効果を示した.
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