| アブストラクト | BACKGROUND: Metformin had been recommended as the first-line treatment for type 2 diabetes since 2006 because of its low cost, high efficacy, and potential to reduce cardiovascular events, and thus death. However, dipeptidyl peptidase-4 (DPP-4) inhibitors are the most commonly prescribed first-line agents for patients with type 2 diabetes in Japan. Therefore, it is necessary to clarify the effect of DPP-4 inhibitors on preventing cardiovascular events, taking into consideration the actual prescription of antidiabetic drugs in Japan. METHODS: This study examined the effect of DPP-4 inhibitors on preventing cardiovascular events. The Japanese Adverse Drug Event Report (JADER) database, a spontaneous reporting system in Japan, and the Japanese Medical Data Center (JMDC) Claims Database, a Japanese health insurance claims and medical checkup database, were used for the analysis. Metformin was used as the DPP-4 inhibitor comparator. Major cardiovascular events were set as the primary endpoint. RESULTS: In the analysis using the JADER database, a signal of major cardiovascular events was detected with DPP-4 inhibitors (IC: 0.22, 95% confidence interval: 0.03-0.40) but not with metformin. In the analysis using the JMDC Claims Database, the hazard ratio of major cardiovascular events for DPP-4 inhibitors versus metformin was 1.01 (95% CI: 0.84-1.20). CONCLUSIONS: A comprehensive analysis using two different databases in Japan, the JADER and the JMDC Claims Database, showed that DPP-4 inhibitors, which are widely used in Japan, have a non-inferior risk of cardiovascular events compared to metformin, which is used as the first-line drug in the United States and Europe. |
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| ジャーナル名 | Journal of clinical medicine |
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| 投稿日 | 2022/9/10 |
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| 投稿者 | Noguchi, Yoshihiro; Yoshizawa, Shunsuke; Tachi, Tomoya; Teramachi, Hitomi |
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| 組織名 | Laboratory of Clinical Pharmacy, Gifu Pharmaceutical University, 1-25-4,;Daigakunishi, Gifu-shi 501-1196, Japan.;Laboratory of Community Healthcare Pharmacy, Gifu Pharmaceutical University,;1-25-4, Daigakunishi, Gifu-shi 501-1196, Japan. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/36078917/ |
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