背景:钠-葡萄糖协同转运蛋白-2(SGLT2)抑制剂的处方由于其额外的益处而不断增加,包括减肥,心脏保护和肾脏保护。因此,人们担心严重药物不良反应(ADR)的潜在上升,如尿路感染,糖尿病酮症酸中毒,体积耗尽,和低血糖。该协会已经宣布了关于适当使用SGLT2抑制剂的建议。我们旨在阐明最近发生的严重ADR,需要停用SGLT2抑制剂或住院治疗。
方法:在这项回顾性队列研究中,我们确定了在2017年4月至2023年3月期间入院时接受SGLT2抑制剂治疗的391例糖尿病患者.其中,68例因ADR以外的原因停用SGLT2抑制剂的患者被排除在外。根据SGLT2抑制剂的治疗期将患者分为2017组和2020组,比较两组患者的ADR发生情况和患者背景。
结果:总共323名合格患者被确定。2020组SGLT2抑制剂的停药率下降(p<0.05)。然而,因虚弱而中断的人数增加(p<0.05)。由于ADR而住院,特别是尿路感染,糖尿病酮症酸中毒,或体积耗尽,没有特别减少(p=0.273)。
结论:这项研究表明,人们对正确使用SGLT2抑制剂的认识有所改善,并且仍需要继续进行启蒙活动。
BACKGROUND: The prescription of sodium-glucose cotransporter-2 (SGLT2) inhibitors have been increasing due to their additional benefits, including weight loss, cardioprotection and renoprotection. Accordingly, there are concerns about the potential rise in severe adverse drug reactions (ADRs), such as urinary tract infections, diabetic ketoacidosis, volume depletion, and hypoglycemia. The Society has announced recommendations on the proper use of SGLT2 inhibitors. We aimed to elucidate the recent occurrence of severe ADRs which need discontinuation of SGLT2 inhibitors or hospitalization.
METHODS: In this retrospective cohort study, we identified 391 diabetic patients who were prescribed SGLT2 inhibitors upon admission to our hospital between April 2017 and March 2023. Of these, 68 patients who discontinued SGLT2 inhibitors for reasons other than ADRs were excluded. Patients were classified into the 2017 group and the 2020 group based on the treatment period of SGLT2 inhibitors, and the occurrence of ADRs and patient backgrounds were compared between the two groups.
RESULTS: A total of 323 eligible patients were identified. Discontinuations of SGLT2 inhibitors decreased in the 2020 group (p < 0.05). However, discontinuations due to frailty increased (p < 0.05). Hospitalization due to ADRs, specifically those due to urinary tract infections, diabetic ketoacidosis, or volume depletion, did not specifically decrease (p = 0.273).
CONCLUSIONS: This study indicated that there has been some improvement in the awareness of the proper use of SGLT2 inhibitors and there is still a need to continue enlightenment activities.