SGLT2阻害剤とGLP-1受容体アゴニスト:既定および新興の指標
Emily Brown1, Hiddo J L Heerspink2, Daniel J Cuthbertson1
1Department of Metabolic and Cardiovascular Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK; Liverpool University Hospitals NHS Foundation Trust, Longmoor Lane, Liverpool, UK.
Lancet (London, England)
|July 3, 2021
まとめ
2型糖尿病患者では,ナトリウム・グルコース・コトランスポーター-2 (SGLT2) 阻害剤とグルカゴン類ペプチド-1 (GLP-1) 受容体アゴニストが心血管と腎臓を有意に保護します. 糖尿病のない人でも 心臓腎臓疾患の管理には これらの薬がますます重要になっています
科学分野:
- 心臓病科
- 内分泌学
- 腎臓科
背景:
- ナトリウム・グルコース・コトランスポーター-2 (SGLT2) 阻害剤とグルカゴン類ペプチド-1 (GLP-1) 受容体アゴニストは,2型糖尿病の低血糖療法として確立されています.
- これらの薬は,体重減少,血圧低下,および重要な心血管保護を含む追加の利点を提供します.
研究 の 目的:
- SGLT2阻害剤とGLP-1受容体アゴニストの既定および新興の利点を検討する.
- 心臓病や他の臨床的症状の管理におけるその役割を強調する.
主な方法:
- 心血管のアウトカム試験のデータをレビューする.
- 効果と安全性に関する証拠の分析
- 現在と将来の臨床応用に関する議論
主要な成果:
- SGLT2阻害剤とGLP-1受容体のアゴニストは,主要な心血管疾患,心不全による入院,および死亡率を減少させます.
- 進行中の研究は,硬質腎臓のエンドポイントを用いて腎臓保護効果を明らかにすることを目的としています.
- それぞれの薬剤クラスには特定の禁忌と予防策があります.
結論:
- これらの薬剤は,血糖値のコントロールに関係なく,心臓・腎臓疾患の患者にとって重要なセカンドラインまたはファーストライン療法です.
- 心血管リスクに対するGLP-1受容体アゴニスト,心不全または慢性腎疾患に対するSGLT2阻害剤.
- 2型糖尿病の患者でも 肥満や肥満を伴う患者での使用を 説得力のある証拠が裏付けています
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