[2012ADA专家访谈]吡格列酮治疗糖尿病的风险与获益.docVIP

[2012ADA专家访谈]吡格列酮治疗糖尿病的风险与获益——Steven E.Nissen教授专访 作者：admin 来源：国际糖尿病 点击数： 9 更新时间：2012年07月05日 【字体：大 中 小】 内容概要：Nissen教授：在当前所有种类的降糖药物中，TZD类药物的降糖作用是最持久的，吡格列酮也是如此。患者应用吡格列酮后很多年血糖都控制得很好。我们最长研究了5年。很多有吡格列酮应用经验的患者告诉我，用药超过5年时效果还很不错。除了吡格列酮之外，目前还没有其他药物被证实降糖作用可以维持这么久。 Steven Nissen ACC前任主席，美国克利夫兰临床中心 心血管医学部主任 International Diabetes: One adverse effect that is a hot topic concerning pioglitazone is bladder cancer. Can you address that issue? ?　　Prof. Nissen: I am just not convinced that there is an effect. The studies that have led to this conclusion are weak and inconclusive and some of them actually go in different directions. Out just today is a long-term analysis from the Kaiser Permanente System that shows a hazard ratio for bladder cancer of 0.98， which essentially is neutral. I think the jury is still out on bladder cancer. If it does occur it occurs at such a low rate as to not be a very significant concern in relation to the cardiovascular benefit. ? 《国际糖尿病》：有关吡格列酮的不良反应，大家比较关注的是膀胱癌。你怎么看？ ?　Nissen教授：我不能确定吡格列酮是否会引起膀胱癌。得出这一结论的几项研究统计学效力弱，结论是不确定的。实际上，其中一些研究得出的结论并不一致。今天在ADA年会上公布了Kaiser数据的长期分析结果，结果显示，膀胱癌的发生风险比是0.98，这基本上是一个中性结果。我认为，膀胱癌的问题还没有定论。即便吡格列酮真的会引起膀胱癌，其发生率也是很低的，与吡格列酮的心血管益处相比，算不上什么大问题。 ?International Diabetes:What is your opinion about the durability of pioglitazone? ?　　Prof. Nissen:? All of the drugs in the TZD class including pioglitazone have the greatest durability of glucose lowering effect of anything we have had yet. Patients continue to respond well to the drug in terms of blood sugar lowering for many years. We have studies out to five years. Many people with clinical experience with the drugs tell me that it goes on well beyond five years. We don’t have anything else that has that durability of proven glucose lowering long-term benefit. ? 《国际糖尿病》：你怎么看吡格列酮的持久降糖作用？ ?　　Nissen教授：在当前所有种类的降糖药物中，TZD类药物的降糖作用是最持久的，吡格列酮也是如此。患者应用吡格列酮后很多年血糖都控制得很好。我们最长研究了5年。很多有吡格列酮应用经验的患者告诉我，用药超过5年时效果还很不错。除了吡格列酮之外，目前还没有其他药物被证实降糖作用可以维持这么久。 ?International Diabetes:Should rosiglitazone and