日本 2 型糖尿病患者中钠糖皮质转运体-2 抑制剂与二肽基肽酶-4 抑制剂的糖尿病视网膜病变风险比较:对真实世界数据的回顾性分析。

IF 3.8 3区 医学 Q2 Medicine
Diabetes Therapy Pub Date : 2024-11-01 Epub Date: 2024-09-30 DOI:10.1007/s13300-024-01649-9
Masaya Koshizaka, Tomoaki Tatsumi, Fumiko Kiyonaga, Yoshinori Kosakai, Yoko Yoshinaga, Mami Shintani-Tachi
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引用次数: 0

摘要

导言:糖尿病视网膜病变(DR)是 2 型糖尿病(T2DM)的一种微血管并发症,是导致失明的主要原因,并对患者的生活质量产生不利影响。我们比较了日本 T2DM 患者使用钠-葡萄糖共转运体-2 抑制剂(SGLT2i)和二肽基肽酶-4 抑制剂(DPP-4i)确诊 DR 的风险:这项日本回顾性队列研究使用了 JMDC 索偿数据库(数据收集时间为 2015 年 1 月至 2022 年 9 月)。采用倾向评分法对新接受 SGLT2i(23,061 例患者)或 DPP-4i(53,986 例患者)治疗且无微血管或大血管疾病记录的 T2DM 患者进行 1:1 匹配(每个匹配组 10,166 例患者)。计算各治疗组的 DR 诊断发生率(IR)和累积 IR;使用 Cox 比例危险模型计算危险比(HR)及其 95% 置信区间(CI),以比较各组之间的风险:SGLT2i组和DPP-4i组的DR诊断IR分别为46.23和57.12/1000人年,SGLT2i组的风险显著低于DPP-4i组(HR 0.83,95% CI 0.75-0.92,P = 0.0003):在这项研究中,在日本,与 DPP-4i 相比,SGLT2i 对无微血管和大血管疾病的 T2DM 患者诊断出 DR 的风险更低。研究结果表明,早期SGLT2i治疗可能有利于预防早期T2DM患者出现DR。本文有图表摘要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparison of the Risk of Diabetic Retinopathy Between Sodium-Glucose Cotransporter-2 Inhibitors and Dipeptidyl Peptidase-4 Inhibitors in Patients with Type 2 Diabetes Mellitus in Japan: A Retrospective Analysis of Real-World Data.

Introduction: Diabetic retinopathy (DR), a microvascular complication of type 2 diabetes mellitus (T2DM), is a leading cause of blindness and has detrimental effects on patients' quality of life. We compared the risk of DR diagnosis with sodium-glucose cotransporter-2 inhibitors (SGLT2i) versus dipeptidyl peptidase-4 inhibitors (DPP-4i) in patients with T2DM in Japan.

Methods: This Japanese retrospective cohort study used the JMDC Claims Database (data collected from January 2015 to September 2022). Patients with T2DM and no record of microvascular or macrovascular diseases who were newly treated with an SGLT2i (23,061 patients) or a DPP-4i (53,986 patients) were matched 1:1 using propensity score (10,166 per matched group). Incidence rates (IRs) and cumulative IRs of DR diagnosis were calculated for each treatment group; hazard ratio (HR) and its 95% confidence interval (CI) were calculated using Cox proportional hazard models to compare the risk between the groups.

Results: The IR of DR diagnosis was 46.23 and 57.12 per 1000 person-years in the SGLT2i and DPP-4i groups, respectively, with a significantly lower risk in the SGLT2i group than in the DPP-4i group (HR 0.83, 95% CI 0.75-0.92, P = 0.0003).

Conclusions: In this study, the risk of DR diagnosis was lower with SGLT2i compared with DPP-4i in patients with T2DM without microvascular and macrovascular diseases in Japan. Findings suggest that early SGLT2i treatment may be beneficial in preventing DR development in early-stage T2DM. Graphical abstract available for this article.

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来源期刊
Diabetes Therapy
Diabetes Therapy Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
6.90
自引率
7.90%
发文量
130
审稿时长
6 weeks
期刊介绍: Diabetes Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all areas of diabetes. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Diabetes Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.
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