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Dipeptidyl Peptidase—4 阻害薬を投与している2 型糖尿病患者へのSodium—glucose Co—transporter2 阻害薬の追加とビグアナイド薬の追加に関する医療情報データベースを用いた比較検討
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JPY
Abstract
Objective The influences of SGLT2 inhibitors(D+S group)versus biguanides(D+B group) as add-on medications on glycemic control, hepatic function, and kidney function were compared in diabetic patients receiving DPP-4 inhibitors in the real-world clinical setting. Method Data were obtained from the Japanese hospital-based medical database constructed by Medical Data Vision Co., Ltd. from January 2013 to September 2017. The propensity score method was used to match patients in the D+S and D+B groups based on their baseline characteristics. The changes in HbA1c, ALT, AST, and eGFR were compared between groups. Results There were no significant differences in HbA1c reduction between the D+S and D+B groups at 6 months and 1 year after treatment. ALT and AST were significantly lower or tended to be lower in the D+S group than in the D+B group at 6 months and 1 year. eGFR was lower in the D+S group than in the D+B group at 6 months of treatment, but there were no significant differences between the two groups at 1 year of treatment. Conclusion It was indicated that SGLT2 inhibitors or biguanides add︱on medications to DPP-4 inhibitors provide equivalent glycemic control in the clinical setting. In addition, SGLT2 inhibitors add-on medications to DPP-4 inhibitors may be more beneficial in patients with abnormal hepatic function tests and may also have renal protective effects.
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