| アブストラクト | AIM: Fluoroquinolone-related hypoglycaemia is rare but may become clinically relevant in individuals at high baseline hypoglycaemic risk, such as patients with diabetes using sulphonylureas. Our population-based cohort study assessed whether fluoroquinolones are associated with an increased risk of severe hypoglycaemia compared with amoxicillin among patients treated with sulphonylureas. MATERIALS AND METHODS: Using the UK's Clinical Practice Research Datalink Aurum linked to hospitalization and vital statistics data, we assembled a base cohort of patients who initiated second-generation sulphonylureas (1998-2020). The study cohort included patients initiating either fluoroquinolones or amoxicillin while on sulphonylureas. Using an intent-to-treat exposure definition, we assessed the 30-day risk of severe hypoglycaemia (hospitalization with or death because of hypoglycaemia) associated with fluoroquinolones compared with amoxicillin. Cox models estimated hazard ratios (HRs) with 95% confidence intervals (CIs) of severe hypoglycaemia after 1:5 matching on previous sulphonylurea use and propensity scores. Secondary analyses were stratified by demographics and glycated haemoglobin. RESULTS: Overall, 143 417 patients initiated fluoroquinolones (n = 13 123) or amoxicillin (n = 130 294) while on sulphonylureas. Compared with amoxicillin, fluoroquinolones were not associated with the risk of severe hypoglycaemia (HR, 1.17; 95% CI, 0.91-1.50). Fluoroquinolones were associated with an increased risk in patients <65 years (HR, 2.90; 95% CI, 1.41-5.97) but not in those >/=65 years (HR, 1.03; 95% CI, 0.79-1.35) in stratified analyses. There was no evidence of effect modification by sex or glycated haemoglobin. CONCLUSIONS: In patients using second-generation sulphonylureas, fluoroquinolones were not associated with an increased risk of severe hypoglycaemia compared with amoxicillin. An increased risk among younger adults is possible. |
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| ジャーナル名 | Diabetes, obesity & metabolism |
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| 投稿日 | 2024/5/3 |
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| 投稿者 | Dimakos, Jenny; Cui, Ying; Platt, Robert W; Renoux, Christel; Filion, Kristian B; Douros, Antonios |
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| 組織名 | Department of Medicine, McGill University, Montreal, Canada.;Centre for Clinical Epidemiology, Lady Davis Institute, Montreal, Canada.;Department of Epidemiology, Biostatistics and Occupational Health, McGill;University, Montreal, Canada.;Department of Pediatrics, McGill University, Montreal, Canada.;Department of Neurology and Neurosurgery, McGill University, Montreal, Canada.;Institute of Clinical Pharmacology and Toxicology, Charite-Universitatsmedizin;Berlin, Berlin, Germany. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/38698651/ |
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