个人-葡萄糖共运输体2抑制剂的比较有效性
HoJin Shin1,2,3, Julie M Paik1,4,5, Brendan M Everett6
1Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
JAMA internal medicine
|January 21, 2025
概括
-葡萄糖共运输体2 (SGLT-2) 抑制剂对心血管有类似的益处. 与empagliflozin相比,低剂量的达帕格利弗洛辛可能会减少心力衰竭住院的好处.
科学领域:
- 心脏病学 心脏病学
- 内分泌学 在内分泌学.
- 药理学 药理学是指药理学的学科.
背景情况:
- SGLT-2 抑制剂对心血管的益处主要来自安慰剂对照试验.
- 单个SGLT-2抑制剂的比较有效性和安全性尚未得到充分证实.
研究的目的:
- 为了比较canagliflozin,dapagliflozin和empagliflozin的心血管结果和安全性.
- 评估效果是否因剂量或心血管疾病史而有所不同.
主要方法:
- 在3个美国索赔数据库 (2014年8月至2020年6月) 中使用目标试验仿真进行的比较有效性研究.
- 对129个混因素进行调整的倾向分数匹配重量.
- 权重考克斯比例危险模型和固定效应元分析.
主要成果:
- 卡纳格利弗洛辛和达帕格利弗洛辛在心脏病发作/中风风险方面表现出与恩帕格利弗洛辛相似的心血管有效性.
- 达帕格利弗洛辛的发起者患心力衰竭住院的风险更高,特别是在低剂量时.
- 卡纳格利弗洛辛和达帕格利弗洛辛的生殖器感染风险较低;达帕格利弗洛辛的DKA风险也较低.
结论:
- 个别的SGLT-2抑制剂在有效剂量下显示出可比的心血管疗效.
- 与empagliflozin相比,低剂量达帕格利弗洛辛可能对心力衰竭住院治疗的益处较小.
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