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| 題 名 | 新機轉藥Dapagliflozin療效探討=Investigation of the Efficacy of Dapagliflozin with a New Mechanism |
|---|---|
| 作 者 | 江文心; 廖淑眉; 程思偉; 王春玉; | 書刊名 | 藥學雜誌 |
| 卷 期 | 33:1=130 2017.03[民106.03] |
| 頁 次 | 頁39-45 |
| 分類號 | 418.271 |
| 關鍵詞 | SGLT2抑制劑; 回溯性病歷回顧; Dapagliflozin; Retrospective chart review; Sodium-glucose co-transporter 2 inhibitor; |
| 語 文 | 中文(Chinese) |
| 中文摘要 | 研究目的:本研究目的在探索對於已經使用 metformin、sulfonylurea、DPP-4 抑 制劑或胰島素的第二型糖尿病病人,加上 dapagliflozin 對病人短期血糖控制的影響。 研究方法:本研究為回溯性病歷回顧研究,透過本醫學中心醫囑電腦系統資料庫篩選 受試者。主要試驗終點為醫囑 dapagliflozin 前後 HbA1c 平均值差異,次要試驗終點為血糖 平均值差異、體重平均值差異。此外,為了瞭解 dapagliflozin 在不同 HbA1c 病人族群的療 效,另將病人依 HbA1c 基準值分為 < 8%、≥ 8%至 < 9%及 ≥ 9%分為三組,比較三組醫囑 dapagliflozin 前後 HbA1c 平均值差異。 研究結果:本研究共收納72名第二型糖尿病且初次醫囑 dapagliflozin 病人,比較加上 dapagliflozin 前後,HbA1c 平均值有達統計上顯著差異 (-1.1%, paired T-test P < 0.0001)。此 外,加上 dapagliflozin 前後空腹血糖平均值 (-44.8mg/dL, paired T-test P < 0.0001) 及體重的平 均值 (-0.9 kg, paired T-test P = 0.003) 亦達到統計上顯著差異。進一步分析,在 HbA1c 基準值 < 8%及 ≥ 8%至 < 9%兩組,加上 dapagliflozin 後 HbA1c 中位數均較基準值減少,且有達到統 計上顯著差異 (Wilcoxon Signed-Rank Test 結果分別為 P = 0.032及 P = 0.002;平均值變化分 別為-0.32%及-0.66%),而在 HbA1c 基準值 ≥ 9%這組 (人數為44人),加上 dapagliflozin 前後 HbA1c 平均值也有達到統計上顯著差異 (-1.4%, paired T-test P < 0.0001)。 結論:對於已經使用 metformin、sulfonylurea、DPP-4抑制劑或胰島素的第二型糖尿病病 人,加上 dapagliflozin 可以顯著改善病人短期血糖控制,且在糖尿病原本控制較差 (HbA1c ≥ 8%) 的病人,效果略優於原本控制較佳 (HbA1c < 8%) 之病人。 |
| 英文摘要 | Objective:To evaluate the efficacy of dapagliflozin in the short-term glycemic control in patients with T2DM under metformin, sulphonylurea, dipeptidyl peptidase-4 inhibitor( DPP4 inhibitor) or insulin treatment. Method:This study is a retrospective chart review research. The subjects are screened by using the computerized physician order entry (CPOE) system of the Medical Center. The primary endpoint was change in hemoglobin A1c(HbA1c) from baseline. Secondary endpoints included changes in plasma glucose level and in body weight. In addition, to understand the efficacy of dapagliflozin in populations with different HbA1c, patients are divided into three groups:< 8%, ≥ 8% to < 9% and ≥ 9% according to the baseline HbA1c , and the differences in average HbA1c among the three groups before and after prescribing dapagliflozin are compared. Result:A total of 72 eligible T2DM patients were included. The mean change from baseline in HbA1c was -1.1% (paired T-test P < 0.0001). Significant reductions in fasting serum glucose (-44.8 mg/dL, paired T-test P < 0.0001) and in body weight (-0.9 kg, paired T-test P = 0.003) were observed. Further analysis, significant reductions in all three groups: HbA1c < 8%, ≥ 8% to < 9% and ≥ 9%, but more reductions were observed in patients with high baseline HbA 1c (-0.32%, Wilcoxon Signed-Rank Test P = 0.032 in HbA1c < 8%, -0.66%, Wilcoxon Signed-Rank Test P = 0.002 in HbA1c ≥ 8% to < 9% and -1.4%, paired T-test P < 0.0001 in HbA1c ≥ 9%). Conclusion:Dapagliflozin achieved significant efficacy on the short-term glycemic control in patients with T2DM under metformin, sulphonylurea, dipeptidyl peptidase-4 inhibitor (DPP4 inhibitor) or insulin treatment. In addition, the efficacy was better to the patients with inadequately controlled glycemia (HbA1c ≥ 8%) than those with well controlled glycemia (HbA1c < 8%). |
本系統中英文摘要資訊取自各篇刊載內容。