Should sulfonylurea be discontinued or maintained at the lowest dose when starting ipragliflozin? A multicenter observational study in Japanese patients with type 2 diabetes

Takahashi, Kiyohiko; Cho, Kyu Yong; Nakamura, Akinobu et al.

Journal of Diabetes Investigation, 2019, 10(2), 429-438

Permalink : https://hdl.handle.net/2115/72899

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アクセス権
open access
URI
https://hdl.handle.net/2115/72899
タイトル
Should sulfonylurea be discontinued or maintained at the lowest dose when starting ipragliflozin? A multicenter observational study in Japanese patients with type 2 diabetes
著者
Takahashi, Kiyohiko ; Cho, Kyu Yong ; Nakamura, Akinobu ; Miya, Aika ; Miyoshi, Arina ; Yamamoto, Chiho ; Nomoto, Hiroshi ; Niwa, Hirokatsu ; Takahashi, Kiyohito ; Manda, Naoki ; Kurihara, Yoshio ; Aoki, Shin ; Ito, Yoichi M ; Atsumi, Tatsuya ; Miyoshi, Hideaki
著者名
Takahashi, Kiyohiko
著者名
Cho, Kyu Yong
e-Rad_Researcher
70552420
著者名
Nakamura, Akinobu
著者名
Miya, Aika
著者名
Miyoshi, Arina
著者名
Yamamoto, Chiho
著者名
Nomoto, Hiroshi
著者名
Niwa, Hirokatsu
著者名
Takahashi, Kiyohito
著者名
Manda, Naoki
著者名
Kurihara, Yoshio
著者名
Aoki, Shin
e-Rad_Researcher
10334236
著者名
Ito, Yoichi M
e-Rad_Researcher
20301905
著者名
Atsumi, Tatsuya
e-Rad_Researcher
30360902
著者名
Miyoshi, Hideaki
言語
英語
キーワード
Glycated hemoglobin
Sodium-glucose cotransporter 2 inhibitor
Sulfonylurea
発行日
2019-03
出版者
Wiley
収録物名
Journal of Diabetes Investigation
巻(号)
10(2)
ページ
429-438
抄録
Aims/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.
資源タイプ
学術雑誌論文
出版タイプ
Version of Record
権利情報
Creative Commons Attribution-NonCommercial 4.0 International
PISSN
2040-1116
関連情報
PMID
30136403
関連情報 (isIdenticalTo)
出版社版DOI
https://doi.org/10.1111/jdi.12913