diaendoСахарный диабетDiabetes mellitus2072-03512072-0378Endocrinology research centre10.14341/DM12929diaendo-12929Research ArticleОригинальные исследованияOriginal StudiesВлияние ингибиторов натрий-глюкозного котранспортера 2 типа дапаглифлозина на показатели общей смертности больных сахарным диабетом 2 типа (исследование CARDIA-MOS, Москва)Influence of type 2 sodium-glucose co-transporter inhibitors (dapagliflozin) on the indicators of total mortality in patients with type 2 diabetes (CARDIA-MOS study, Moscow)https://orcid.org/0000-0002-9944-2997АнциферовМ. Б.AntsiferovM. B.

Михаил Борисович Анциферов - доктор медицинских наук, профессор; eLibrary SPIN: 1035–4773.

Москва

Mikhail B. Antsiferov - MD, PhD, professor; eLibrary SPIN: 1035–4773.

Moscow

yakov@mdwrt.comhttps://orcid.org/0000-0001-8289-0032ДемидовН. А.DemidovN. A.

Николай Александрович Демидов - кандидат медицинских наук, врач-эндокринолог; eLibrary SPIN: 7715-4508.

Москва, г. Московский, мкр. 3, стр. 7, 108111

Nikolay A. Demidov - MD, PhD; eLibrary SPIN: 7715-4508.

7, Moskovskiy, microraion 3, Moscow

nicolay13@mail.ruБалбероваМ. А.BalberovaM. A.

Мария Александровна Балберова - врач-эндокринолог; eLibrary SPIN: 7263-5503.

Москва

Maria A. Balberova - MD; eLibrary SPIN: 7263-5503.

Moscow

bode@cra-club.ruhttps://orcid.org/0000-0002-2196-8278ЛобановаО. В.LobanovaO. V.

Ольга Владимировна Лобанова - врач-эндокринолог.

Москва

Olga V. Lobanova – MD.

Moscow

shgb@zdrav.mos.ruhttps://orcid.org/0000-0002-0885-0371МудриковаИ. Г.MudrikovaI. G.

Ирина Геннадьевна Мудрикова - врач-эндокринолог; eLibrary SPIN: 8965-5850.

Москва

Irina G. Mudrikova - MD; eLibrary SPIN: 8965-5850.

Moscow

gp219@zdrav.mos.ruhttps://orcid.org/0000-0001-8440-7809ГусенбековаД. Г.GusenbekovaD. G.

Динара Гаджимагомедовна Гусенбекова - кандидат медицинских наук, врач-эндокринолог; eLibrary SPIN: 5332-2890.

Москва

Dinara G. Gusenbekova - MD, PhD; eLibrary SPIN: 5332-2890.

Moscow

gp219@zdrav.mos.ruЭндокринологический диспансерРоссияEndocrinological DispensaryRussian FederationЩербинская городская больницаРоссияShcherbinsk City HospitalRussian FederationБольница КузнечикиРоссияKuznechiki HospitalRussian FederationГородская больница г. МосковскийРоссияHospital of Moscovskiy cityRussian FederationГородская поликлиника № 219РоссияCity Polyclinic No. 219Russian Federation202230112022255439448Copyright © Анциферов М.Б., Демидов Н.А., Балберова М.А., Лобанова О.В., Мудрикова И.Г., Гусенбекова Д.Г., 20222022Анциферов М.Б., Демидов Н.А., Балберова М.А., Лобанова О.В., Мудрикова И.Г., Гусенбекова Д.Г.Antsiferov M.B., Demidov N.A., Balberova M.A., Lobanova O.V., Mudrikova I.G., Gusenbekova D.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.dia-endojournals.ru/jour/article/view/12929ОБОСНОВАНИЕ

ОБОСНОВАНИЕ. Широкое применение в клинической практике препаратов с кардио- и нефропротективными свойствами, в частности ингибиторов натрий-глюкозного котранспортера 2 типа (иНГЛТ-2), базируется на результатах крупномасштабных международных рандомизированных исследований. Между тем отсутствуют данные, демонстрирующие возможности влияния данных препаратов на показатели смертности в реальной клинической практике у российских пациентов. Для изучения данного вопроса было проведено исследование CARDIA-MOS на популяции больных сахарным диабетом 2 типа (СД2) г. Москвы.

ЦЕЛЬ

ЦЕЛЬ. Изучить влияние иНГЛТ-2 на показатели общей смертности больных СД2 Москвы.

МАТЕРИАЛЫ И МЕТОДЫ

МАТЕРИАЛЫ И МЕТОДЫ. Для оценки частоты различных исходов были сформированы две выборки пациентов по заранее определенным критериям: 1) пациенты, начавшие терапию иНГЛТ-2 (дапаглифлозином) в 2017 г. и получавшие его в течение 48 мес; 2) контрольная группа пациентов (не получавших иНГЛТ-2), соответствующая основной группе по ключевым показателям: возраст, длительность СД, наличие сердечно-сосудистых заболеваний, использование инсулинотерапии, уровень гликированного гемоглобина (НbА1с).

РЕЗУЛЬТАТЫ

РЕЗУЛЬТАТЫ. На 1-м этапе работы был проведен анализ данных 499 пациентов, начавших лечение дапаглифлозином в 2017 г., а также 499 пациентов контрольной группы (n=998). Исходные характеристики пациентов в основном были сопоставимыми. Показатели систолического артериального давления и уровня НbА1с до исследования были хуже в группе дапаглифлозина. Применение дапаглифлозина ассоциировалось со снижением относительного риска (ОР) смерти от всех причин на 39% (ОР 0,614; 95% ДИ 0,417–0,903; р=0,013), приводило к снижению уровня НbА1с на 0,8% (с 8,5 до 7,7%, p<0,001) на протяжении 48 мес наблюдения.

ЗАКЛЮЧЕНИЕ

ЗАКЛЮЧЕНИЕ. Использование дапаглифлозина в терапии больных СД2 позволяет снизить показатели общей смертности и улучшить показатели гликемического контроля.

BACKGROUND

BACKGROUND: The widespread use in clinical practice of drugs with cardio- and nephroprotective properties, in particular, sodium-glucose cotransporter type 2 inhibitors (SGLT2i), is based on the results of large-scale international randomized trials. Meanwhile, there are no data demonstrating the possibility of the influence of these drugs on mortality rates in real clinical practice in Russian patients. To study this issue, a CARDIA-MOS study was conducted on a population of patients with type 2 diabetes (T2DM) in Moscow.

AIM

AIM: To study the effect of SGLT2i on the total mortality of patients with T2DM in Moscow.

MATERIALS AND METHODS

MATERIALS AND METHODS: To assess the frequency of different outcomes, two samples of patients were formed according to predetermined criteria: 1) patients who started therapy with SGLT2i (dapagliflozin) in 2017; 2) a control group of patients corresponding to the main group in terms of key indicators: age, duration of T2DM, presence of cardiovascular diseases, use of insulin therapy, HbA1c level.

RESULTS

RESULTS: Firstly, an analysis of the data of 499 patients who started treatment with dapagliflozin in 2017, as well as 499 patients in the control group (n = 998) was made. The baseline characteristics of the patients were generally comparable. Pre-study SBP and HbA1c were worse in the dapagliflozin group. The use of dapagliflozin was associated with a 39% reduction in the relative risk of death from all causes (RR 0.614, 95% CI 0.417–0.903, p = 0.013), led to a decrease in HbA1c levels by 0.8% (from 8.5 to 7.7%, p<0.001) for 48 months. observations. The safety profile of dapagliflozin was comparable to that of the control group

CONCLUSION

CONCLUSION: The use of dapagliflozin in the treatment of patients with T2DM can reduce overall mortality and improve glycemic control.

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The authors declare that there are no conflicts of interest present.