Cardio-reno-vascular protection in type 2 diabetes mellitus: new insights into pharmacotherapeutic management.

IF 2.5 3区 医学 Q3 PHARMACOLOGY & PHARMACY
Expert Opinion on Pharmacotherapy Pub Date : 2024-08-01 Epub Date: 2024-08-19 DOI:10.1080/14656566.2024.2392017
Oliwia Janota, Hanna Kwiendacz, Anna Olejarz, Aleksandra Włosowicz, Patrycja Pabis, Janusz Gumprecht, Uazman Alam, Gregory Y H Lip, Katarzyna Nabrdalik
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引用次数: 0

Abstract

Introduction: From 2008 and following the withdrawal of rosiglitazone, obligatory cardiovascular outcomes trials are performed for glucose lowering drugs introduced to the market to ensure their cardiovascular (CV) safety. Paradoxically, these studies have demonstrated CV safety but also shown additional cardio-reno-vascular protection of some therapeutic agents. Additionally, nonsteroidal mineralocorticoid receptor antagonists (ns-MRA) have emerged as novel drugs for cardio - and renoprotection in type 2 diabetes (T2D) and chronic kidney disease (CKD). In addition to atherosclerotic CV disease, heart failure (HF) and CKD are important clinical problems in T2D leading to poor quality of life and premature death as such cardio-reno-vascular protection is an important clinical issue.

Areas covered: We provide new insights into pharmacotherapeutic cardio-reno-vascular protection in T2D based on the new glucose lowering drugs and ns-MRA. PUB MED/CINAHL/Web of Science/Scopus were searched (May 2024).

Expert opinion: The conventional glucose lowering approach alone which was implemented for decades is now replaced by the use of disease modifying drugs which lower the rates of CV events, HF decompensation, hospitalization due to HF, slow progression of CKD and all-cause mortality. Indeed, the choice of medications in T2D should be focused on underlying co-morbidities with cardio-reno-vascular protection rather than a gluco-centric approach.

2 型糖尿病的心肾血管保护:药物治疗管理的新见解。
简介自 2008 年起,在罗格列酮退出市场后,上市的降糖药物必须进行心血管结果试验,以确保其心血管(CV)安全性。矛盾的是,这些研究在证明心血管安全性的同时,也显示出某些治疗药物对心血管的额外保护作用。此外,非甾体类矿物皮质激素受体拮抗剂(ns-MRA)已成为 2 型糖尿病(T2D)和慢性肾脏病(CKD)心血管和肾脏保护的新型药物。除了动脉粥样硬化性心血管疾病外,心力衰竭(HF)和慢性肾脏病也是 2 型糖尿病的重要临床问题,会导致患者生活质量下降和过早死亡,因此心肾血管保护是一个重要的临床问题:我们以新型降糖药物和 ns-MRA 为基础,就 T2D 的药物治疗对心脑血管的保护提出了新见解。检索了 PUB MED/CINAHL/Web of Science/Scopus(2024 年 5 月):专家观点:几十年来一直采用的单纯降糖的传统方法,如今已被使用改变疾病的药物所取代,这些药物可降低心血管事件、心房颤动失代偿、心房颤动住院、慢性肾脏病缓慢进展和全因死亡率。事实上,T2D 患者在选择药物时应重点考虑潜在的合并疾病,以保护心脑血管,而不是以血糖为中心。
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来源期刊
CiteScore
5.60
自引率
3.10%
发文量
163
审稿时长
4-8 weeks
期刊介绍: Expert Opinion on Pharmacotherapy is a MEDLINE-indexed, peer-reviewed, international journal publishing review articles and original papers on newly approved/near to launch compounds mainly of chemical/synthetic origin, providing expert opinion on the likely impact of these new agents on existing pharmacotherapy of specific diseases.
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