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Objective To evaluate the efficacy and safety of different doses of Ipragliflozin in the treatment of type 2 diabetes patients.Methods The randomized controlled trials (RCTs) about Ipragliflozin in treatment of type 2 diabetes patients were retrieved from the databases,including Cochrane Library,PubMed,Embase,Medline,CNKI,Wangfang,VIP and CBM.The data were extracted and evaluated by two researchers independently,and the Meta-analysis was performed via RevMan5.2.Results A total of 10 RCTs involving 1 928 patients were included.The results of Meta-analysis showed that glycosylated hemoglobin (HbA1c)[12.5 mg/d:MD=-0.46,95％CI (-0.69,-0.23);25 mg/d:MD=-0.97,95％CI (-1.00,-0.94);50 mg/d:MD=-0.94,95％CI (-1.20,-0.69);100 mg/d:MD=-0.93,95％CI (-1.72,-0.15);150 mg/d:MD=-0.57,95％CI (-0.89,-0.26);200 mg/d:MD=-0.74,95％CI (-1.14,-0.34);300 mg/d:MD=-0.64,95％CI (-0.86,-0.43)],fasting blood glucose (FPG) [12.5 mg/d:MD=-1.52,95％CI(-1.58,-1.47);25 mg/d:MD=-1.98,95％CI (-2.04,-1.93);50 mg/d:MD=-2.53,95％CI(-2.59,-2.48);100 mg/d:MD=-3.27,95％CI(-3.32,-3.21);150 mg/d:MD=-1.29,95％CI (-1.90,-0.68);200 mg/d:MD=-3.34,95％CI (-4.78,-1.90);300 mg/d:MD=-1.73,95％CI(-2.28,-1.18)] and body weight [12.5mg/d:MD=-0.92,95％CI(-1.36,-0.47);25 mg/d:MD=-1.30,95％CI (-1.81,-0.79);50 mg/d:MD=-1.58,95％CI (-1.80,-1.35);100 mg/d:MD=-1.31,95％CI(-1.65,-0.97);150 mg/d:MD=-1.51,95％CI (-2.42,-0.60);300 mg/d:MD=-1.73,95％ CI (-2.63,-0.83)] were significantly reduced in the different doses of Ipragliflozin group than that in the placebo group,and the dose of 50 mg/d and 100 mg/d were better.There was no significant difference in the incidence rate of the overall adverse reaction,hypoglycemic events,urinary tract infection and genital infection between the different doses of Ipragliflozin group and the placebo group (P＞0.05),but data showed that dose of 50 mg/d was more security than 100 mg/d (RR:1.02 vs.2.18,1.83 vs.2.88,1.01 vs.1.72,1.85 vs.2.98).Conclusion Ipragliflozin is effective and safe for the patients with type 2 diabetes,which could effectively control the patients' HbA1c,FPG and body weight,and 50 mg/d may be the best dose.
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Objective To evaluate the efficacy and safety of different doses of Ipragliflozin in the treatment of type 2 diabetes patients.Methods The randomized controlled trials (RCTs) about Ipragliflozin in treatment of type 2 diabetes patients were retrieved from the databases,including Cochrane Library,PubMed,Embase,Medline,CNKI,Wangfang,VIP and CBM.The data were extracted and evaluated by two researchers independently,and the Meta-analysis was performed via RevMan5.2.Results A total of 10 RCTs involving 1 928 patients were included.The results of Meta-analysis showed that glycosylated hemoglobin (HbA1c)[12.5 mg/d:MD=-0.46,95％CI (-0.69,-0.23);25 mg/d:MD=-0.97,95％CI (-1.00,-0.94);50 mg/d:MD=-0.94,95％CI (-1.20,-0.69);100 mg/d:MD=-0.93,95％CI (-1.72,-0.15);150 mg/d:MD=-0.57,95％CI (-0.89,-0.26);200 mg/d:MD=-0.74,95％CI (-1.14,-0.34);300 mg/d:MD=-0.64,95％CI (-0.86,-0.43)],fasting blood glucose (FPG) [12.5 mg/d:MD=-1.52,95％CI(-1.58,-1.47);25 mg/d:MD=-1.98,95％CI (-2.04,-1.93);50 mg/d:MD=-2.53,95％CI(-2.59,-2.48);100 mg/d:MD=-3.27,95％CI(-3.32,-3.21);150 mg/d:MD=-1.29,95％CI (-1.90,-0.68);200 mg/d:MD=-3.34,95％CI (-4.78,-1.90);300 mg/d:MD=-1.73,95％CI(-2.28,-1.18)] and body weight [12.5mg/d:MD=-0.92,95％CI(-1.36,-0.47);25 mg/d:MD=-1.30,95％CI (-1.81,-0.79);50 mg/d:MD=-1.58,95％CI (-1.80,-1.35);100 mg/d:MD=-1.31,95％CI(-1.65,-0.97);150 mg/d:MD=-1.51,95％CI (-2.42,-0.60);300 mg/d:MD=-1.73,95％ CI (-2.63,-0.83)] were significantly reduced in the different doses of Ipragliflozin group than that in the placebo group,and the dose of 50 mg/d and 100 mg/d were better.There was no significant difference in the incidence rate of the overall adverse reaction,hypoglycemic events,urinary tract infection and genital infection between the different doses of Ipragliflozin group and the placebo group (P＞0.05),but data showed that dose of 50 mg/d was more security than 100 mg/d (RR:1.02 vs.2.18,1.83 vs.2.88,1.01 vs.1.72,1.85 vs.2.98).Conclusion Ipragliflozin is effective and safe for the patients with type 2 diabetes,which could effectively control the patients' HbA1c,FPG and body weight,and 50 mg/d may be the best dose.
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OBJECTIVE:To investigate the role of clinical pharmacists in individualized antiplatelet therapy for a patient with subacute stent thrombosis after PCI.METHODS:Clinical pharmacists participated in the therapy for a myocardial infarction patient with diabetes,and the patient suffered from subacute stent thrombosis at the fourth day after PCI.Clinical pharmacists suggested performing clopidogrel-related gene detection [Cytochrome P450(CYP)2C19] through comprehensively analyzing the complexity of the lesion,the time of stent thrombosis,the number of stent implantations and combined diseases,etc.According to detection result (CYP2C19* 1/*2),clinical pharmacists suggested to additionally use Cilostazol tablets 50 mg,po,bid,on the basis of previous dual antiplatelet therapy;additionally use Alprostadil injection 10 μg,ivgtt,qd to improve microcirculation.Pharmaceutical care as therapeutic evaluation,ADR monitoring were performed,and medication education as medication notes and dietary adjustments were also provided.RESULTS:Physicians adopted the suggestions of clinical pharmacists;the patient was recovered and discharged from hospital.After discharge,the disease condition kept stable due to persistent aspirin+clopidogrel+cilostazol triple antiplatelet therapy.CONCLUSIONS:Drug metabolizing enzyme is an important cause of individual differences in antiplatelet effects and toxicity,and its gene polymorphism is closely related with clinical outcome and terminal event.Clinical pharmacists should play professional skill to assist physician to access and interpret relevant information,and formulate and adjust individualized antiplatelet therapy after considering disease condition,combined diseases and genotypes,so as to guarantee safe and effective drug use.