患有排泄功能障碍风险的男性中SGLT2抑制剂和尿路感染:VigiBase分析
Zhiyu Qian1,2, Jonathan Song1,2, Alyssa Jones1,2
1Department of Urological Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Urology practice
|September 6, 2024
概括
-葡萄糖共运输体-2 (SGLT2) 抑制剂与男性尿路感染 (UTIs) 和复杂的UTIs风险增加有关. 老年男性面临更高的复杂尿路感染的风险,可能是由于排泄功能障碍.
科学领域:
- 药监和药物安全 药监和药物安全
- 泌尿病学和脏病学
- 内分泌学和糖尿病管理
背景情况:
- -葡萄糖共运输体-2 (SGLT2) 抑制剂被广泛用于治疗2型糖尿病.
- 男性患者,特别是老年人,由于潜在的排泄功能障碍,可能会增加尿路感染 (UTI) 的风险.
- 了解与男性SGLT2抑制剂相关的特定风险对于安全处方至关重要.
研究的目的:
- 调查SGLT2抑制剂使用与男性尿路感染和复杂尿路感染风险之间的关联.
- 为了特别评估老年男性 (≥65岁) 中的这种风险,他们更容易受到排泄功能障碍的影响.
主要方法:
- 使用全球VigiBase报告 (19672022) 采用药监督案例非案例研究设计.
- 使用不成比例分析,包括报告几率比率 (ROR) 和经验贝叶斯估计器 (EBE) 来评估风险.
- 在65岁时进行了年龄分层和敏感性分析,将SGLT2抑制剂与其他糖尿病药物进行了比较.
主要成果:
- 在使用SGLT2抑制剂的男性中,观察到尿路感染 (ROR 6.75) 和复杂尿路感染 (ROR 8.09) 的风险增加.
- 在65岁及以上的男性中,复杂尿路感染的风险特别明显 (ROR 8.79).
- 敏感性分析证实了重要的关联,表明了一致的安全信号.
结论:
- 在男性人群中,SGLT2抑制剂与尿路感染和复杂尿路感染的风险增加有关.
- 年长的男性,可能与良性前列腺增生相关的排泄功能障碍,表现出更明显的复杂尿路感染的风险.
- 处方者在开始使用SGLT2抑制剂时应考虑均衡的风险-益处评估,特别是在敏感的男性人群中.
相关概念视频
01:26Urinary Tract Infection I: Introduction
Urinary tract infections (UTIs) impact various parts of the urinary system, including the kidneys, ureters, bladder, and urethra. These infections are generally bacterial, with Escherichia coli being the most common causative agent, often originating from the gastrointestinal tract. However, other bacteria, such as Staphylococcus saprophyticus, Klebsiella pneumoniae, and Proteus mirabilis, are also known to cause UTIs. The type, location, and underlying complexity of the UTI guide both...
01:25Urinary Tract Infection II: Pathophysiology
The pathophysiology of urinary tract infections (UTIs) encompasses several progressive stages, beginning with bacterial colonization and culminating in potential systemic complications if untreated. UTIs are primarily initiated by bacteria, such as Escherichia coli, which often originate from the gastrointestinal tract and migrate to the urinary system through the periurethral area. This migration can occur via several routes, including improper hygiene practices, sexual activity, or...
01:30Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care
A healthcare provider can diagnose a urinary tract infection (UTI) through several methods:Medical History and Symptoms: The provider will take a detailed medical history and ask about symptoms such as frequent urination, burning sensation during urination, and lower abdominal pain.Urinalysis: A clean-catch urine sample is collected in a sterile container and tested for the presence of bacteria, white blood cells (leukocytes), nitrites, blood, and protein. The presence of leukocytes and...
01:26Urinary Tract Calculi II: Pathophysiology and Clinical Manifestations
Renal calculi, commonly termed kidney stones, are crystalline solid masses that form in the kidneys but can occur at any point within the urinary system, encompassing the kidneys, ureters, bladder, and urethra.The pathophysiology of renal stones involves several key factors: supersaturation of the urine with stone-forming constituents, changes in urine pH, a decrease in urine volume, and the presence of substances that promote or inhibit stone formation.Supersaturation of Urine: This is the...
01:30Urinary Tract Calculi III: Medical Management
The diagnosis of renal calculi involves several imaging techniques, including non-contrast CT scans and ultrasound. These methods help visualize kidney stones, assess their size and location, and detect possible obstructions. Additionally, Measuring urine pH is useful for diagnosing specific stone types, such as struvite (alkaline pH) and uric acid stones (acidic pH). Cystine stones are primarily linked to cystinuria, a genetic condition. A urinalysis helps detect blood in the urine (hematuria)...
01:25Urinary Tract Calculi VI: Surgical Management
Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...