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雑誌文献

medicina59巻12号

2022年11月発行

文献概要

特集 避けて通れない心不全診療—総合内科力・循環器力を鍛えよう! 心不全の新薬について

新しい薬:SGLT2阻害薬は糖尿病がなくても処方すべきですか?

著者: 三木隆幸1 伊野祥哉1

所属機関: 1王子総合病院循環器内科・糖尿病内科

ページ範囲:P.2242 - P.2247

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◎心機能の低下した心不全(HFrEF)患者を対象にした大規模臨床試験で,SGLT2阻害薬は心血管死または心不全イベントを有意に減少させた.この効果は糖尿病の有無に関係なく認められた.
◎SGLT2阻害薬は,心機能が保たれた心不全(HFpEF)に対して有効性を示した初めての薬剤である.
◎SGLT2阻害薬は心不全患者の腎保護をもたらすのみならず,慢性腎臓病患者の予後を改善することも示されている.

参考文献

1)Chao EC, Henry RR:SGLT2 inhibition--a novel strategy for diabetes treatment. Nat Rev Drug Discov 9:551-559, 2010
2)Sano M:A new class of drugs for heart failure;SGLT2 inhibitors reduce sympathetic overactivity. J Cardiol 71:471-476, 2018
3)Lytvyn Y, et al:Sodium glucose cotransporter-2 inhibition in heart failure;Potential mechanisms, clinical applications, and summary of clinical trials. Circulation 136:1643-1658, 2017
4)Braunwald E:Gliflozins in the management of cardiovascular disease. N Engl J Med 386:2024-2034, 2022
5)Dyck JRB, et al:Cardiac mechanisms of the beneficial effects of SGLT2 inhibitors in heart failure;Evidence for potential off-target effects. J Mol Cell Cardiol 167:17-31, 2022
6)McMurray JJV, et al:Dapagliflozin in patients with heart failure and reduced ejection fraction. N Engl J Med 381:1995-2008, 2019
7)Packer M, et al:Cardiovascular and renal outcomes with empagliflozin in heart failure. N Engl J Med 383:1413-1424, 2020
8)Zannad F, et al:SGLT2 inhibitors in patients with heart failure with reduced ejection fraction;A meta-analysis of the EMPEROR-Reduced and DAPA-HF trials. Lancet 396:819-829, 2020
9)Anker SD, et al:Empagliflozin in heart failure with a preserved ejection fraction. N Engl J Med 385:1451-1461, 2021
10)Heerspink HJL, et al:Dapagliflozin in patients with chronic kidney disease. N Engl J Med 383:1436-1446, 2020
11)Okunrintemi V, et al:Sodium-glucose co-transporter-2 inhibitors and atrial fibrillation in the cardiovascular and renal outcome trials. Diabetes Obes Metab 23:276-280, 2021
12)Voors AA, et al:The SGLT2 inhibitor empagliflozin in patients hospitalized for acute heart failure;A multinational randomized trial. Nat Med 28:568-574, 2022
13)Mone P, et al:Empagliflozin improves cognitive impairment in frail older adults with type 2 diabetes and heart failure with preserved ejection fraction. Diabetes Care 45:1247-1251, 2022
14)日本循環器学会/日本心不全学会:2021年JCS/JHFSガイドラインフォーカスアップデート版 急性・慢性心不全診療 https://www.j-circ.or.jp/cms/wp-content/uploads/2021/03/JCS2021_Tsutsui.pdf(2022年8月閲覧)
15)McDonagh TA, et al:2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure:Developed by the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology(ESC)With the special contribution of the Heart Failure Association(HFA)of the ESC. Eur J Heart Fail 24:4-131, 2022
16)Heidenreich PA, et al:2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure:A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation 145:e895-e1032, 2022

掲載誌情報

出版社:株式会社医学書院

電子版ISSN:1882-1189

印刷版ISSN:0025-7699

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