2024-03-29T12:32:07Zhttps://eprints.lib.hokudai.ac.jp/dspace-oai/requestoai:eprints.lib.hokudai.ac.jp:2115/728992022-11-17T02:08:08Zhdl_2115_20040hdl_2115_121Should sulfonylurea be discontinued or maintained at the lowest dose when starting ipragliflozin? A multicenter observational study in Japanese patients with type 2 diabetesTakahashi, KiyohikoCho, Kyu YongNakamura, AkinobuMiya, AikaMiyoshi, ArinaYamamoto, ChihoNomoto, HiroshiNiwa, HirokatsuTakahashi, KiyohitoManda, NaokiKurihara, YoshioAoki, ShinIto, Yoichi MAtsumi, TatsuyaMiyoshi, HideakiGlycated hemoglobinSodium-glucose cotransporter 2 inhibitorSulfonylurea490Aims/Introduction: We investigated the difference in efficacy and safety between discontinuation and maintaining of sulfonylurea when adding a sodium-glucose cotransporter 2 inhibitor. Materials and Methods: In the present multicenter, prospective observational study, 200 patients with type 2 diabetes treated with sulfonylurea and with a need to add ipragliflozin were enrolled and divided into two groups: discontinued sulfonylurea (Discontinuation group) or maintained sulfonylurea, but at the lowest dose (Low-dose group) when adding ipragliflozin. We compared the two groups after 24 weeks using propensity score matching to adjust for differences between the groups. Results: In the matched cohort (58 patients in each group), baseline characteristics of both groups were balanced. The primary outcome of the proportion of patients with non-exacerbation in glycated hemoglobin after 24 weeks was 91.4% in the Low-dose group and 75.9% in the Discontinuation group, a significant difference (P = 0.024). However, bodyweight was significantly decreased in the Discontinuation group compared with the Low-dose group (-4.4 ± 2.1 kg vs -2.9 ± 1.9 kg, P < 0.01). Similarly, liver enzyme improvement was more predominant in the Discontinuation group. A logistic regression analysis showed that high-density lipoprotein cholesterol, age and sulfonylurea dose were independent factors associated with non-exacerbation of glycated hemoglobin in the Discontinuation group. Conclusions: The purpose of using ipragliflozin should be considered when making the decision to discontinue or maintain sulfonylurea at the lowest dose. Furthermore, low high-density lipoprotein cholesterol level, low dose of sulfonylurea and younger age were possible markers to not show worsening of glycemic control by discontinuing sulfonylurea.WileyJournal Articleapplication/pdfapplication/pdfhttp://hdl.handle.net/2115/72899https://eprints.lib.hokudai.ac.jp/dspace/bitstream/2115/72899/4/Takahashi_et_al-2019-Journal_of_Diabetes_Investigation.pdfhttps://eprints.lib.hokudai.ac.jp/dspace/bitstream/2115/72899/3/jdi12913-sup-0001-figs1-2.pdf2040-1116Journal of Diabetes Investigation1024294382019-03enginfo:pmid/30136403info:doi/10.1111/jdi.12913http://creativecommons.org/licenses/by-nc/4.0/publisher