功能对日本抗糖尿病药物选择的影响:使用J-DREAMS数据库进行现实分析
Masashi Kubota1, Mitsuru Ohsugi1,2, Kohjiro Ueki1,3
1Department of Diabetes, Endocrinology and Metabolism, National Center for Global Health and Medicine, Japan Institute for Health Security, Tokyo, Japan.
日本2型糖尿病患者表现出不断发展的抗糖尿病药物选择. 像SGLT2抑制剂和GLP-1受体激动剂这样的新药越来越多地使用,处方量身定制为功能.
科学领域:
- 内分泌学 在内分泌学.
- 药理学 药理学是指药理学的学科.
- 腎臟病學 (nephrology) 是一種醫學專業.
背景情况:
- 2型糖尿病的管理需要仔细考虑功能.
- 选择抗糖尿病药物可以显著影响患者的治疗结果,特别是在功能受损患者中.
- 现实世界的数据为当前的处方实践提供了关键的见解.
研究的目的:
- 对日本2型糖尿病患者的抗糖尿病药物的功能特异性处方模式进行分析.
- 根据估计的淋巴细胞过率 (eGFR) 来确定一线和二线治疗药物选择的趋势.
- 检查这些处方模式的时间变化随着时间的推移.
主要方法:
- 对J-DREAMS注册表 (2015-2023) 的回顾性分析.
- 根据功能对药物处方进行分层 (eGFR ≥60 vs <60 mL/min/1.73 m2).
- 倾向性得分匹配用于比较功能组之间的处方比例.
主要成果:
- 在24,868名患者中,36.1%的eGFR<60毫升/分钟/1.73米2.
- 不管功能如何,二乙酶-4 (DPP-4) 抑制剂是最常见的第一线药物.
- 作为二线疗法,使用-葡萄糖携运输体-2 (SGLT2) 抑制剂和葡萄糖类-1 (GLP-1) 受体激活剂增加,SGLT2 抑制剂在正常功能中受益,GLP-1 受体激活剂在最近的功能下降组中受益.
结论:
- 日本对2型糖尿病的处方模式正在转向早期采用SGLT2抑制剂和GLP-1受体激动剂.
- 药物选择越来越多地根据患者的功能量身定制.
- 这些趋势表明,我们正在朝着更个性化,更有效的抗糖尿病治疗策略迈进.
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