| アブストラクト | OBJECTIVE: The hypoglycemic potential of beta-blockers among users of sulfonylureas, drugs that strongly increase the risk of this potentially fatal adverse effect, is not well understood. Our population-based cohort study assessed the potential association between concomitant use of sulfonylureas and beta-blockers versus use of sulfonylureas alone and the risk of severe hypoglycemia. RESEARCH DESIGN AND METHODS: Using the U.K. Clinical Practice Research Datalink Aurum, we included patients initiating sulfonylureas between 1998 and 2020, excluding those with beta-blocker use in the past 6 months. Time-dependent Cox models estimated hazard ratios (HRs) with 95% CIs of severe hypoglycemia (hospitalization with or death resulting from hypoglycemia; ICD-10 codes E16.0, E16.1, and E16.2) associated with current concomitant use of sulfonylureas and beta-blockers compared with current sulfonylurea use alone, adjusted for baseline confounders. We also compared current concomitant use of sulfonylureas and non-cardioselective versus cardioselective beta-blockers. RESULTS: Our cohort included 252,869 initiators of sulfonylureas (mean age 61.3 years; 43% female). Median follow-up was 7.9 years. The crude incidence rate of severe hypoglycemia was 7.8 per 1,000 per year. Concomitant use of sulfonylureas and beta-blockers was associated with an increased risk of severe hypoglycemia compared with sulfonylurea use alone (HR 1.53; 95% CI 1.42-1.65). There was no difference in the risk between concomitant use of sulfonylureas and noncardioselective beta-blockers and concomitant use of sulfonylureas and cardioselective beta-blockers (HR 0.95; 95% CI 0.74-1.24). CONCLUSIONS: beta-blockers could further increase the risk of severe hypoglycemia when used concurrently with sulfonylureas. beta-blocker cardioselectivity did not seem to play a major role in this regard. |
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| 組織名 | Department of Medicine, McGill University, Montreal, Quebec, Canada.;Centre for Clinical Epidemiology, Lady Davis Institute, Montreal, Quebec, Canada.;Department of Epidemiology, Biostatistics and Occupational Health, McGill;University, Montreal, Quebec, Canada.;Department of Pediatrics, McGill University, Montreal, Quebec, Canada.;Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec,;Canada.;Institute of Clinical Pharmacology and Toxicology, Charite-Universitatsmedizin;Berlin, Berlin, Germany. |
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