SGLT-2 抑制剂作为二甲双胍附加疗法治疗 2 型糖尿病患者的生殖器和尿路感染风险：韩国的一项回顾性队列研究,Pharmacology Research & Perspectives

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SGLT-2 抑制剂作为二甲双胍附加疗法治疗 2 型糖尿病患者的生殖器和尿路感染风险：韩国的一项回顾性队列研究
Pharmacology Research & Perspectives ( IF 2.9 ) Pub Date : 2022-01-10 , DOI: 10.1002/prp2.910
Hyeri Yang ₁ , Eunmi Choi ₁ , Eunjun Park ₁ , Eonji Na ₁ , Soo Youn Chung ₁ , Bonggi Kim ₁ , Soon Young Han ₁

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钠-葡萄糖协同转运蛋白 2 (SGLT-2) 抑制剂是一种抗糖尿病药物，具有与生殖器和尿路感染风险相关的安全问题。本研究评估了与二肽基肽酶 4 (DPP-4) 抑制剂相比，在 2 型糖尿病 (T2DM) 患者中使用 SGLT-2 抑制剂作为二甲双胍附加疗法的生殖器和尿路感染风险，磺酰脲（SU）和噻唑烷二酮（TZD）。我们使用 2014 年至 2017 年在韩国的 NHIS（国民健康保险）数据库进行了一项回顾性队列研究。招募了年龄≥19 岁和在开药前被诊断为 T2DM 的患者。结果是生殖器和尿路感染。使用 Cox 的比例风险模型进行分析，如下 1：1 倾向得分匹配以计算具有 95% 置信区间 (CI) 的风险比 (HR)。在纳入研究的 107131 名患者中，共有 7738、7145 和 2175 名患者被分配到 DPP-4 抑制剂、SU 和 TZD 比较组，使用基于 7741 人的每个比较者的倾向评分 (PS)在评估的药物 SGLT-2 抑制剂组中。与 DPP-4 抑制剂（HR：2.39，95% CI：2.07–2.76）、SU（HR：3.23，95% CI：2.73–3.81）和 TZD（ HR: 3.23, 95% CI: 2.35–4.44)，作为二甲双胍的附加疗法。对于尿路感染的风险也观察到了类似的结果。总之，与 DPP-4 抑制剂、SU 和 TZD 相比，SGLT-2 抑制剂与更高的生殖器和尿路感染风险显着相关。

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Risk of genital and urinary tract infections associated with SGLT-2 inhibitors as an add-on therapy to metformin in patients with type 2 diabetes mellitus: A retrospective cohort study in Korea

Sodium-glucose cotransporter-2 (SGLT-2) inhibitors are antidiabetic drugs with associated safety concerns regarding the risk of genital and urinary tract infections. This study assessed the risk of genital and urinary tract infections associated with prescription of SGLT-2 inhibitors as an add-on therapy to metformin in patients with type 2 diabetes mellitus (T2DM) compared to dipeptidyl peptidase-4 (DPP-4) inhibitors, sulfonylurea (SU), and thiazolidinedione (TZD). We conducted a retrospective cohort study using the NHIS—National Health Insurance—Database in Korea from 2014 to 2017. Patients aged ≥19 years and those diagnosed with T2DM prior to drug prescription were enrolled. The outcomes were genital and urinary tract infections. Analysis was performed using Cox's proportional hazard model following 1:1 propensity score matching to calculate the hazard ratio (HR) with a 95% confidence interval (CI). Among the 107 131 patients included in the study, a total of 7738, 7145, and 2175 patients were assigned to the DPP-4 inhibitors, SU, and TZD comparator groups, using the propensity score (PS) of each comparator based on 7741 people in the assessed drug SGLT-2 inhibitor group. SGLT-2 inhibitors were associated with a higher risk of genital infections than DPP-4 inhibitors (HR: 2.39, 95% CI: 2.07–2.76), SU (HR: 3.23, 95% CI: 2.73–3.81), and TZD (HR: 3.23, 95% CI: 2.35–4.44), as an add-on therapy to metformin. Similar results were observed for the risk of urinary tract infections. In conclusion, SGLT-2 inhibitors are significantly associated with a higher risk of genital and urinary tract infections compared to DPP-4 inhibitors, SU, and TZD.

更新日期：2022-02-10

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