Impact of sitagliptin combination therapy and hypoglycemia in Japanese patients with type 2 diabetes: a multi-center retrospective observational cohort study
Abstract 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 hypog...
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| Format: | Article |
| Language: | English |
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BMC
2020-06-01
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| Series: | Journal of Pharmaceutical Health Care and Sciences |
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| Online Access: | http://link.springer.com/article/10.1186/s40780-020-00169-5 |
| _version_ | 1811328720974118912 |
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| author | Tomoyuki Saito Hirotoshi Ohmura Shuko Nojiri Hiroyuki Daida |
| author_facet | Tomoyuki Saito Hirotoshi Ohmura Shuko Nojiri Hiroyuki Daida |
| author_sort | Tomoyuki Saito |
| collection | DOAJ |
| description | Abstract 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 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 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 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. |
| first_indexed | 2024-04-13T15:30:07Z |
| format | Article |
| id | doaj.art-73f67f4788db4f1284f00d51e3afe025 |
| institution | Directory Open Access Journal |
| issn | 2055-0294 |
| language | English |
| last_indexed | 2024-04-13T15:30:07Z |
| publishDate | 2020-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Pharmaceutical Health Care and Sciences |
| spelling | doaj.art-73f67f4788db4f1284f00d51e3afe0252022-12-22T02:41:24ZengBMCJournal of Pharmaceutical Health Care and Sciences2055-02942020-06-01611810.1186/s40780-020-00169-5Impact of sitagliptin combination therapy and hypoglycemia in Japanese patients with type 2 diabetes: a multi-center retrospective observational cohort studyTomoyuki Saito0Hirotoshi Ohmura1Shuko Nojiri2Hiroyuki Daida3Department of Cardiovascular Medicine, Juntendo University Graduate School of MedicineDepartment of Cardiovascular Medicine, Juntendo University Graduate School of MedicineJuntendo University, Medical Technology Innovation CenterDepartment of Cardiovascular Medicine, Juntendo University Graduate School of MedicineAbstract 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 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 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 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.http://link.springer.com/article/10.1186/s40780-020-00169-5HypoglycemiaDipeptidyl-peptidase IV inhibitorsBeta-blockers,Type 2 diabetes mellitus |
| spellingShingle | Tomoyuki Saito Hirotoshi Ohmura Shuko Nojiri Hiroyuki Daida Impact of sitagliptin combination therapy and hypoglycemia in Japanese patients with type 2 diabetes: a multi-center retrospective observational cohort study Journal of Pharmaceutical Health Care and Sciences Hypoglycemia Dipeptidyl-peptidase IV inhibitors Beta-blockers, Type 2 diabetes mellitus |
| title | Impact of sitagliptin combination therapy and hypoglycemia in Japanese patients with type 2 diabetes: a multi-center retrospective observational cohort study |
| title_full | Impact of sitagliptin combination therapy and hypoglycemia in Japanese patients with type 2 diabetes: a multi-center retrospective observational cohort study |
| title_fullStr | Impact of sitagliptin combination therapy and hypoglycemia in Japanese patients with type 2 diabetes: a multi-center retrospective observational cohort study |
| title_full_unstemmed | Impact of sitagliptin combination therapy and hypoglycemia in Japanese patients with type 2 diabetes: a multi-center retrospective observational cohort study |
| title_short | Impact of sitagliptin combination therapy and hypoglycemia in Japanese patients with type 2 diabetes: a multi-center retrospective observational cohort study |
| title_sort | impact of sitagliptin combination therapy and hypoglycemia in japanese patients with type 2 diabetes a multi center retrospective observational cohort study |
| topic | Hypoglycemia Dipeptidyl-peptidase IV inhibitors Beta-blockers, Type 2 diabetes mellitus |
| url | http://link.springer.com/article/10.1186/s40780-020-00169-5 |
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