GLP-1受体激动剂的使用和自杀的风险死亡自杀的风险
Peter Ueda1, Jonas Söderling1, Viktor Wintzell1
1Division of Clinical Epidemiology, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden.
JAMA internal medicine
|September 3, 2024
概括
这项研究发现,使用类似葡萄糖-1 (GLP-1) 受体激活剂的患者中没有自杀死亡或自我伤害的风险增加. 在2型糖尿病管理中常见的这些药物的使用,在这些严重的结果方面似乎是安全的.
科学领域:
- 药物监督 药物监督 药物监督
- 临床流行病学临床流行病学
- 代谢障碍 代谢障碍 代谢障碍
背景情况:
- 人们担心,使用类似葡萄糖-1 (GLP-1) 受体激活剂与增加自杀或自我伤害之间的潜在联系存在.
- 评估这种风险对于患者的安全至关重要,特别是在2型糖尿病患者中.
研究的目的:
- 评估在现实临床环境中启动GLP-1受体激素治疗与自杀死亡风险之间的关联.
- 调查二次结果,包括非致命的自我伤害和事件抑郁/焦虑障碍.
主要方法:
- 一项积极比较的新用户队列研究利用了来自瑞典和丹麦 (2013-2021) 的全国性注册数据.
- 包括成人 (18-84岁) 开始使用GLP-1受体激动剂或-葡萄糖共传输体-2 (SGLT2) 抑制剂.
- 倾向性得分权重和元分析被用来计算主要和次要结果的危险比率 (HRs).
主要成果:
- 该研究包括124,517名GLP-1受体激动剂使用者和174,036名SGLT2抑制剂使用者.
- 没有观察到自杀死亡的统计学上显著增加的风险 (HR,1.25;95% CI,0.83-1.88).
- 发现自杀死亡和非致命自伤风险降低 (HR,0.83;95% CI,0.70-0.97),但与抑郁症/焦虑症无显著关联 (HR,1.01;95% CI,0.97-1.06).
结论:
- 这项大型队列研究表明,GLP-1受体激动剂的使用与自杀死亡,自我伤害或相关精神健康障碍的风险增加无关.
- 自杀死亡很少发生,观察到的绝对风险增加的上置信限值是最小的.
- 这些发现支持GLP-1受体激动剂在常规临床实践中关于自杀和自我伤害的安全性.
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