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이 논문의 연구 히스토리 (4)
2014
제 2형 당뇨병 환자에서 metformin/dipeptidyl peptidase-4 저해제 병용요법과 metformin/sulfonylurea 병용요법의 효능과 부작용 비교
박지혜
임상약학
2014.01
학위논문
제 2형 당뇨병 환자에서 sitagliptin과 metformin 고정 복합제 투여와 단일제 병용간의 복약 순응도 및 효과에 대한 비교 연구
박지혜
임상약학
2014.01
학위논문
제2형 당뇨병 환자에서 시타글립틴과 메트포민 고정 복합제 투여와 단일제 병용간의 복약 순응도, 효과 및 약가에 대한 비교 연구
박지혜
,
곽혜선
,
이병구
외 1명
한국임상약학회지
2014.01
학술저널
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초록· 키워드
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Objective: Treatment with sulfonylureas in combination with metformin improves glycemic control in type 2 diabetes mellitus (T2DM), but is associated with hypoglycemia and weight gain. This retrospective study aims to compare the effectiveness of dipeptidylpeptidase-4 (DPP-4) inhibitors and sulfonylureas as an add-on therapy to metformin in patients with T2DM. Methods: Data from medical records of 355 T2DM patients received therapy either DPP-4 inhibitors (DPP-4 inhibitor group) or sulfonylurea (SU group) in combination with metformin from 1 March 2009 to 30 September 2011 were retrospectively reviewed. Of total 355 patients, 231 patients were in DPP-4 inhibitor group and 124 patients were in SU group. Baseline Hemoglobin A1c (HbA1c) level in SU group was higher than DPP-4 inhibitor group with a statistically significant difference (8.6% vs. 7.8%). Comparative analysis between DPP-4 inhibitor group and SU group was performed for HbA1c values, amounts of HbA1c changes, and rates of HbA1c changes from baseline at 6-month intervals and incidence rates of major cardiocerebral events. Results: SU group showed larger HbA1c changes in both amounts and rates compared to DPP-4 inhibitor group, although statistical significance was not found in all study periods. Proportions of patients with stable HbA1c <6.5% or 7% were significantly higher in DPP-4 inhibitor group than SU group (<6.5%: 30.4% vs. 13.4%, <7%: 72.3% vs. 41.2%). Time to achieve stable HbA1c <6.5% was not significantly different, but time to achieve stable HbA1c <7% was shorter in DPP4 inhibitor group than SU group with a significant difference. The incidence rate of cardiocerebral events in group of patients with or without previous events was 1.7%, not significantly lower than that in DPP-4 inhibitor group (4.0%). For newly encountered cardiocerebral events during the treatment, incidence rates of two groups did not differ significantly. Conclusion: DPP-4 inhibitors were as effective as sulfonylureas in achieving the HbA1c goal of less than 6.5% or 7% and cardiocerebral event rates did not differ between the two drugs.
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참고문헌 (20)
참고문헌 신청
Bloomgarden ZT. / 2006 / Lower baseline glycemia reduces apparent oral agent glucose-lowering efficacy / Diabetes Care 29 (9) : 2137 ~ 2139
DeFronzo RA. / 2010 / Relationship of baseline HbA1c and efficacy of current glucose-lowering therapies : a meta-analysis of randomized clinical trials / Diabet Med 27 (3) :
Esposito K. / 2011 / Dipeptidyl peptidase-4 inhibitors and HbA1c target of < 7% in type 2 diabetes : meta-analysis of randomized controlled trials / Diabetes Obes Metab 1
Filozof C. / 2010 / A comparison of efficacy and safety of vildagliptin and gliclazide in combination with metformin in patients with Type 2 diabetes inadequately controlled
Gallwitz B. / 2013 / Linagliptin is more effective than glimepiride at achieving a composite outcome of target HbA1c < 7% with no hypoglycaemia and no weight gain over 2 y
DeFronzo RA. / 2010 / Relationship of baseline HbA1c and efficacy of current glucose-lowering therapies : a meta-analysis of randomized clinical trials / Diabet Med 27 (3) :
Esposito K. / 2011 / Dipeptidyl peptidase-4 inhibitors and HbA1c target of < 7% in type 2 diabetes : meta-analysis of randomized controlled trials / Diabetes Obes Metab 1
Filozof C. / 2010 / A comparison of efficacy and safety of vildagliptin and gliclazide in combination with metformin in patients with Type 2 diabetes inadequately controlled
Gallwitz B. / 2013 / Linagliptin is more effective than glimepiride at achieving a composite outcome of target HbA1c < 7% with no hypoglycaemia and no weight gain over 2 y
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