Impact of sitagliptin combination therapy and hypoglycemia in Japanese patients with type 2 diabetes: a multi-center retrospective observational cohort study.
Beta-blockers,
Dipeptidyl-peptidase IV inhibitors
Hypoglycemia
Type 2 diabetes mellitus
Journal
Journal of pharmaceutical health care and sciences
ISSN: 2055-0294
Titre abrégé: J Pharm Health Care Sci
Pays: England
ID NLM: 101672177
Informations de publication
Date de publication:
2020
2020
Historique:
received:
01
03
2020
accepted:
11
05
2020
entrez:
11
6
2020
pubmed:
11
6
2020
medline:
11
6
2020
Statut:
epublish
Résumé
Patients with diabetes are at higher risk of developing polypharmacy because of the high frequency of comorbidities. There have been several reports on the hypoglycemic risk of the combination of hypoglycemic agents and other medications. This study aimed to investigate the hypoglycemic risk of drug-drug interaction between sitagliptin and other oral hypoglycemic agents or antihypertensive agents in Japanese patients with type 2 diabetes. From January 2010 to March 2012, a total of 3247 patients were recruited and evaluated at outpatient clinics at Juntendo University Hospital, other satellite hospitals, and private clinics. This study was a sub-analysis of the Sitagliptin Registration Type 2 Diabetes-Juntendo Collaborating Project. Participants were limited to those treated with oral hypoglycemic agents, excluding insulin users, to investigate the association of the first hypoglycemic events with oral hypoglycemic agents or other medications within 6 months after starting sitagliptin. The factors related to the first hypoglycemic event were analyzed using Cox regression analysis. In total, 2956 patients with a mean age of 65.1 ± 11.3 years were included. A total of 46 hypoglycemic events (1.6%) were observed. One patient had severe hypoglycemia followed by emergency transport to the hospital. Sitagliptin was not associated with hypoglycemia, but its combination with sulfonylurea (hazard ratio: 4.42, 95% confidential interval: 1.36-14.42) or β-blocker (hazard ratio, 3.50, 95% confidential interval: 1.54-7.96) was significantly associated with hypoglycemia. The drug-drug interactions between sitagliptin and sulfonylurea or β-blocker likely increases the hypoglycemic risk in Japanese patients with type 2 diabetes. Pharmacists should consider potential adverse events from drug-drug interaction in type 2 diabetes with polypharmacy, particularly those who are managed by several doctors or clinics.
Sections du résumé
BACKGROUND
BACKGROUND
Patients with diabetes are at higher risk of developing polypharmacy because of the high frequency of comorbidities. There have been several reports on the hypoglycemic risk of the combination of hypoglycemic agents and other medications. This study aimed to investigate the hypoglycemic risk of drug-drug interaction between sitagliptin and other oral hypoglycemic agents or antihypertensive agents in Japanese patients with type 2 diabetes.
METHODS
METHODS
From January 2010 to March 2012, a total of 3247 patients were recruited and evaluated at outpatient clinics at Juntendo University Hospital, other satellite hospitals, and private clinics. This study was a sub-analysis of the Sitagliptin Registration Type 2 Diabetes-Juntendo Collaborating Project. Participants were limited to those treated with oral hypoglycemic agents, excluding insulin users, to investigate the association of the first hypoglycemic events with oral hypoglycemic agents or other medications within 6 months after starting sitagliptin. The factors related to the first hypoglycemic event were analyzed using Cox regression analysis.
RESULTS
RESULTS
In total, 2956 patients with a mean age of 65.1 ± 11.3 years were included. A total of 46 hypoglycemic events (1.6%) were observed. One patient had severe hypoglycemia followed by emergency transport to the hospital. Sitagliptin was not associated with hypoglycemia, but its combination with sulfonylurea (hazard ratio: 4.42, 95% confidential interval: 1.36-14.42) or β-blocker (hazard ratio, 3.50, 95% confidential interval: 1.54-7.96) was significantly associated with hypoglycemia.
CONCLUSIONS
CONCLUSIONS
The drug-drug interactions between sitagliptin and sulfonylurea or β-blocker likely increases the hypoglycemic risk in Japanese patients with type 2 diabetes. Pharmacists should consider potential adverse events from drug-drug interaction in type 2 diabetes with polypharmacy, particularly those who are managed by several doctors or clinics.
Identifiants
pubmed: 32518665
doi: 10.1186/s40780-020-00169-5
pii: 169
pmc: PMC7271486
doi:
Types de publication
Journal Article
Langues
eng
Pagination
13Informations de copyright
© The Author(s) 2020.
Déclaration de conflit d'intérêts
Competing interestsHirotoshi Ohmuara has received lecture fees from Takeda Pharmaceutical Co., MSD K.K., AstraZeneca K.K., and Shionogi & Co. Ltd. and research funds from Pfizer Co., MSD K.K., and Takeda Pharmaceutical Co. Ltd. Hiroyuki Daida has received lecture fees from AstraZeneca K.K., MSD K.K., Kowa Pharmaceutical Company Ltd., Sanofi-Aventis K.K., GlaxoSmithKline K.K., Shionogi & Co. Ltd., Daiichi-Sankyo Company, Limited, Takeda Pharmaceutical Co. Ltd., Mitsubishi Tanabe Pharma Corp., Pfizer Co. Ltd., and Astellas Pharma Inc. and research funds from Takeda Pharmaceutical Co. Ltd., Bristol-Myers Squibb Company, Nippon Boehringer Ingelheim Co. Ltd., Astellas Pharma Inc., Novartis Pharma K.K., MSD K.K., Sanofi-Aventis K.K., Otsuka Pharmaceutical Co. Ltd., Dainippon Sumitomo Pharma Co. Ltd., Pfizer Co. Ltd., Kowa Pharmaceutical Company Ltd., Shionogi & Co. Ltd., AstraZeneca K.K., Teijin Limited, and Morinaga Milk Industry Co. Ltd. Tomoyuki Saito and Shuko Nojiri have nothing to declare.
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