ESC 2013:DPP-4抑制剂类糖尿病药物未增加心血管风险

2013-09-03 MedSci MedSci原创

近日,在欧洲心脏协会(ESC)年度会议上,研究人员详细陈述了过去两年针对16492例服用Onglyza和5380例服用Nesina的糖尿病患者的心血管风险研究结果。总体上讲,两项研究表明用于治疗2型糖尿病的二肽基肽酶-4(DPP-4)抑制剂类药物不会导致心脏病发作,但可能会因心脏不能充分泵血,引发心衰。同时,布利甘-妇女医院研究人员称心衰只是个例,还需进一步研究确认。因此,阿斯利康和百时美施贵宝宣

近日,在欧洲心脏协会(ESC)年度会议上,研究人员详细陈述了过去两年针对16492例服用Onglyza和5380例服用Nesina的糖尿病患者的心血管风险研究结果。总体上讲,两项研究表明用于治疗2型糖尿病的二肽基肽酶-4(DPP-4)抑制剂类药物不会导致心脏病发作,但可能会因心脏不能充分泵血,引发心衰。同时,布利甘-妇女医院研究人员称心衰只是个例,还需进一步研究确认。因此,阿斯利康和百时美施贵宝宣称尽管Onglyza未降低心血管风险,但也不会增加其风险。

以往的研究指出糖尿病患者死于心肌梗死、脑卒中以及其他心脑血管病的风险比没有糖尿病的人高一倍,约75%患者最终死于心脑血管并发症。内科医师和药品监管人员一直担心糖尿病药物的心血管安全性。2011年的一项Meta分析结果指出DPP-4抑制剂可直接作用于心脏、诱导血管扩张并改善内皮功能,因此可能具有一定的心脏保护作用。

事实上,研究人员目前尚无法确定哪种糖尿病药物不仅安全,且有益于患者心血管。对此, ESC发言人Heinz Drexel医生表示,DPP-4抑制剂在治疗糖尿病的过程中不会引起患者体重增加,有些体重超重的患者体重还会下降,在一定程度上减轻了心衰的风险。

Nesina由百时美施贵宝和阿斯利康共同推广和销售的DPP-4抑制剂类糖尿病药物,上年度销售额为7.09亿美元,分析师预计到2018 年将达2.47亿美元。目前,默克的Januvia在该类药物市场占主导地位,上年度销售额为50亿美元,但因其可能引发胰腺炎和胰管上皮化生的风险,本年已有所下滑。幸运的是,欧洲药品管理局(EMA),在对所有可用的非临床及临床数据进行审查之后,发现其中有"许多方法存在局限性和可能偏差",表示没有新的证据显示这类药物有胰腺损伤风险。此外,有14000例患者参与的针对Januvia的心血管风险研究正在进行中,明年将公布结果。

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    2014-07-05 jklm09
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    2013-09-05 gaoxiaoe
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