资讯内容 Content

[ADA2012]吡格列酮治疗糖尿病的获益风险比
——陈名道教授专访
国际糖尿病网版权所有,谢绝任何形式转载,侵犯版权者必予法律追究。

作者:陈名道 2012/6/11 15:00:00    加入收藏
内容概要:陈教授:每个药物都同时有益处和风险。没有益处,就不能称之为药物。如果大量服用某种药物很长时间的话,药物会有不良反应。每个药物都有不良反应,所以作为医生,我们要考虑药物的疗效和风险,两者都是重要的因素。临床上我们通常会遵循学会的糖尿病治疗指南。指南推荐二甲双胍为一线治疗药物,之后是磺脲类药物和其他药物,最后应用胰岛素。

  陈名道教授 上海瑞金医院主任医师,上海市内分泌研究所中西医结合研究室主任、《中华内分泌代谢杂志》副主编、编辑部主任

  <International Diabetes>: Based on the concept of comprehensive management of diabetes, the risk to benefit ratio is regarded as an important tool in the treatment of diabetes. Would you introduce the concepts of risks and benefits in the treatment of diabetes?
  Prof. Chen: Every drug has benefits and risks. Without benefits it would not be a drug. If you take a large amount of a drug for a long duration, some drugs have side effects. Every drug has side effects so as doctors, we need to consider the potency and the risk. These are important factors. Usually in the clinic we follow the guidelines of the society such as the diabetes guidelines. They use metformin as first-line then sulfonylureas and other drugs and finally insulin for diabetes.
  《国际糖尿病》:基于糖尿病综合管理理念,获益-风险比是衡量糖尿病治疗的重要工具。您能否介绍下糖尿病治疗获益-风险比这个概念?
  陈教授:每个药物都同时有益处和风险。没有益处,就不能称之为药物。如果大量服用某种药物很长时间的话,药物会有不良反应。每个药物都有不良反应,所以作为医生,我们要考虑药物的疗效和风险,两者都是重要的因素。临床上我们通常会遵循学会的糖尿病治疗指南。指南推荐二甲双胍为一线治疗药物,之后是磺脲类药物和其他药物,最后应用胰岛素。

  <International Diabetes>: How are you applying that in the clinic now?
  Prof. Chen:  Usually we follow the guidelines of the society such as the diabetes guidelines. They use metformin as first-line then sulfonylureas and other drugs and finally insulin for diabetes.

  《国际糖尿病》:如何在临床上应用获益-风险比这一概念?
  陈教授:通常,我们会遵循学会的糖尿病治疗指南。指南推荐二甲双胍为一线治疗药物,之后是磺脲类药物和其他药物,最后应用胰岛素。

  <International Diabetes>:  Pioglitazone is the only widely used TZD drug and its cardiovascular effects have drawn attention recently. At this year’s ADA Meeting, there are three studies presented as posters adding new evidence for the cardiovascular effects of pioglitazone. One of these posters is focused on major adverse cardiovascular events. What is your opinion about the findings from the three studies especially from the PROactive six-year extension study?
  Prof. Chen:  For pioglitazone, the PROactive study showed that cardiovascular events actually decreased with this drug. Now from the three posters, we also see after six years follow-up that decreasing tendency still exists whether pioglitazone treatment was stopped or was still being used. So a residual effect still exists or if pioglitazone treatment is continued, the effect will be increased i.e. the control of diabetes will be better than if you had stopped pioglitazone. These information means the concern for cardiovascular side effects really doesn’t exist with pioglitazone treatment.
  《国际糖尿病》:吡格列酮是唯一被广泛应用的TZD类药物,最近吡格列酮的心血管效应吸引了大家的注意。在今年的ADA年会上,有三个壁报展示了吡格列酮心血管效应的最新研究结果。其中一个壁报针对的是重要心血管不良事件。您怎么看这三项研究,尤其是PROactive 6年延长研究?
  陈教授:PROactive研究显示吡格列酮能够减少心血管事件。本届ADA年会上展示的三项壁报报告进一步表明,在PROactive研究基础上随访6年后,吡格列酮减少心血管事件的趋势依然存在,且无论其仍在应用还是已经停用均为如此,提示吡格列酮停用后存在残留的心血管效应。如果继续吡格列酮治疗,其带来的心血管效应会进一步强化,相比停用能够更好地控制糖尿病。这些研究结果提示我们不必担忧吡格列酮治疗会带来心血管不良效应。 

  <International Diabetes>:  So how should the clinician interpret those three new studies that are presented this year? What should they gain from that new information?
  Prof. Chen: The new information means the concern for cardiovascular side effects really doesn’t exist with pioglitazone treatment.

  《国际糖尿病》:临床医生应如何解读这三个研究?能从中得到哪些新信息?
  陈教授:新信息就是不必担忧吡格列酮治疗会带来心血管不良效应。 



[1]  [2]  下一页

 延伸阅读
网站用户: 国际糖尿病网友 时间:2012/10/1 12:15:18
Hey, you're the goto expert. Thanks for hngaing out here.

注册

网友评论仅供其表达个人看法,并不表明国际糖尿病同意其观点或证实其描述。 发表评论需登陆

相关视频

 
关于本站 | 设为首页 | 加入收藏 | 站长邮箱 | 友情链接 | 版权申明

国际糖尿病(www.idiabetes.com.cn)对刊载的所有文章、视频、幻灯、音频等资源拥有全部版权。未经本站许可,不得转载。

国际糖尿病 版权所有  2008-2018 idiabetes.com.cn  All Rights Reserved