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罗格列酮(rosiglitazone)属于噻唑烷二酮类(TZD)口服降糖药,其主要作用机制是提高肌肉及脂肪组织对胰岛素的敏感性,从而改善血糖控制。由葛兰素史克公司制造的马来酸罗格列酮(商品名:文迪亚)自上市以来由于其肯定持久的降糖作用而被广泛应用于临床。 相似文献
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罗格列酮(Rosiglitazone RSG)是一种新型的口服噻唑烷二酮类(thiazolidinedione,TZDs)降糖药,其作用靶点是过氧化物酶体增殖活化受体(peroxidsome proliferatoractiyated receptor,PPARγ),该受体是一种蛋白质,存在于胰岛素敏感组织脂肪、骨骼肌和肝组织中。PPARγ属于转录因子中核激素受体类,可与核醛X受体(RXR)相结合形成异二聚体, 相似文献
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《药物不良反应杂志》编辑部 《药物不良反应杂志》2010,12(5):376-376
罗格列酮[商品名为文迪雅(Avandia)]为噻唑烷二酮类降糖药,能提高胰岛素敏感性,用于治疗2型糖尿病。该药于1999年6月在美国上市,2000年在中国上市。2007年5月Nissen等在《新英格兰医学杂志》上发表了一篇有关罗格列酮安全性的荟萃分析报告,认为罗格列酮能增加心肌梗死和心血管死亡风险。 相似文献
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进入21世纪,2型糖尿病日益肆虐,目前全球糖尿病患者已近2亿,其中中国占了20%左右.为了对抗这场全球化的"战争",研究人员日以继夜地研发更为有效的糖尿病治疗"武器".近10年来,糖尿病新药层出不穷,包括噻唑烷二酮类、GLP-1、DPP-Ⅳ抑制剂、各种胰岛素类似物等药物相继问世.面对数目众多的新药,如何选择和应用对患者来说最有效、最安全的药物?要实现这一点,我们需要尽可能多的有关药物有效性和安全性的循证依据,才能从中加以甄别和筛选,发现真正有效的"利器".显然,作为噻唑烷二酮类代表药物的罗格列酮已经经过了10年的考验,证明了其在糖尿病治疗领域中价值和突出地位. 相似文献
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罗格列酮非降糖作用的研究进展 总被引:1,自引:1,他引:1
罗格列酮(Rosiglitazone,RSG)属于噻唑烷二酮类口服降糖药,主要通过结合和活化过氧化物酶体增殖物激活受体γ(PPAR-γ)起作用.其可促进脂肪和其它细胞的分化,增强细胞对胰岛素作用的敏感性,减轻胰岛素抵抗(IR),系胰岛素增敏药.近年来的研究发现,该药除具有降糖作用外,还具有多方面的药理作用,可用于多种疾病的治疗. 相似文献
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罗格列酮治疗2型糖尿病临床疗效观察 总被引:1,自引:0,他引:1
目的确器罗格列酮治疗2型糖尿病临床疗效。方法116例2型糖尿病患者随机分为治疗组和对照组各58例,对照组采用常规降糖治疗.治疗组在对照组基础上给予罗格列酮4mg,po,qd。两组治疗16周后观察指标。结果两组患者治疗前后比较。①治疗组治疗前后FBG、2hBG、HbAlc、FINS、2hPlns及胰岛素抵抗指数比较差异都具有统计学意义(P均〈0.05)。对照组FBG、2hBG和HbAle治疗前后比较差异有统计学意义(P均〈0.05),FINS、2hPlns和IRI治疗前后比较差异无统计学意义(P均〉0.05)。治疗后两组各项指标比较差异具有统计学意义(P均〈0.05)。②对照组治疗前后TC、TG、HDL—C和LDL—C比较差异均无统计学意义(P均〉0.05)。治疗组治疗前后TG和HDL-C比较差异具有统计学意义(P均〈0.05)。与对照组治疗后比较差异也具有统计学意义(P均〈0.05);而TC和LDL-C治疗前后比较及与对照组治疗后比较差异也无统计学意义(P均〉0.05)。结论罗格列酮对2型糖尿病患者有明显的改善胰岛素抵抗、降低血糖、改善脂代谢紊乱等作用,且治疗后不发生严重不良反应。是治疗2型糖尿病安全有效的药物,值得临床推广使用。 相似文献
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目的分析冠心病合并糖尿病患者应用罗格列酮治疗对心血管事件发生率的影响。方法回顾性分析本科住院106例冠心病合并糖尿病患者,依据治疗方案差异分为两组:对照组52例.予以常规治疗:研究组54例,常规治疗联合应用罗格列酮。随访1年,比较两组的主要心血管事件(MACE)发生率的差异,如:接受血运重建术、心肌梗死、充血性心力衰竭、脑卒中以及心源性猝死。结果与对照组相比,研究组的充血性心力衰竭发生率显著升高(P〈0.05),但是接受血运重建术、心肌梗死、脑卒中以及心源性猝死等MACE的发生率虽有升高,但差异无统计学意义(P〉0.05)。结论冠心病合并糖尿病患者应用罗格列酮治疗对缺血性MACE无明显影响,但能增加充血性MACE风险。 相似文献
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罗格列酮相关心血管事件概述 总被引:2,自引:0,他引:2
罗格列酮为噻唑烷二酮类口服降糖药,能改善胰岛素敏感性,用于治疗2型糖尿病.近年,罗格列酮的心血管风险受到人们关注.一项荟萃分析显示:罗格列酮组与对照组比较,心肌梗死的优势比(OR)为1.43,[95%可信区间(13/)1.03~1.98,P=0.03];心血管性死亡OR为1.64,(95%Cl0.98~2.74,P=0.06),表明罗格列酮与心肌梗死及心血管性死亡有关联.然而,最近RECORD中期研究显示:罗格列酮组心肌梗死49例,对照组40例(P=0.34),而两组的充血性心力衰竭分别为47例和22例(P=0.003),表明罗格列酮不增加心肌梗死和心血管性死亡风险,但可使充血性心力衰竭风险增加.另外,FDA 2008年发布了有关罗格列酮的用药指南和处方信息,罗格列酮禁用于严重心力衰竭患者.因此,使用罗格列酮时应权衡利弊,并应个体化用药. 相似文献
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Rahul Jain C. Daniel Mullins Helen Lee Winston Wong 《Research in social & administrative pharmacy》2012,8(1):47-59
BackgroundMeta-analyses of oral hypoglycemic agents (OHAs) revealed that rosiglitazone increased the risk of myocardial infarction (MI) and heart failure (HF) and that pioglitazone increased the risk of HF and decreased the risk of MI.ObjectiveTo characterize the change in the pattern of use of OHAs immediately after the publication of these meta-analyses on May 21, 2007.MethodsPharmacy and medical claims data for a managed care organization were analyzed for patients continuously enrolled from January 1, 2005, to November 30, 2007, with at least 1 pharmacy claim for OHA in the 13-month period between November 1, 2006, and November 30, 2007. A 5-month pre-publication period (November 1, 2006, through March 31, 2007) was compared with a 5-month post-publication period (July 1, 2007, through November 30, 2007) using a differences-in-differences multinomial logistic regression. This regression explored discontinuation; continuation with monotherapy or adding another drug; and switching to a drug different from the index monotherapy drug after adjusting for gender, age, type of insurance, past 1-year history of MI or HF, and risk factors for MI and HF in the past 1 year.ResultsThe relative rate of switching to nonindex drug in the postpublication relative to prepublication was 2.64 (P = .046) for monotherapy rosiglitazone users and 0.72 (P = .583) for monotherapy pioglitazone users. The differences-in-differences estimate of the rate of switching to nonindex drugs for monotherapy rosiglitazone users was 3.64 (P = .090) times higher relative to the estimate for monotherapy pioglitazone users.ConclusionThe pattern of use differed fundamentally between monotherapy rosiglitazone users and users of all other monotherapy OHAs in the postperiod. Not only were monotherapy rosiglitazone patients switching to non-rosiglitazone drugs at a higher rate, but the rate also was more than 3 times higher than similar switches among monotherapy pioglitazone users in the postperiod relative to the preperiod. This shows that the market response as observed by patient/prescriber decisions to the adverse news was interpreted narrowly to monotherapy rosiglitazone, and there is little or no spillover to the other drugs. Therefore, this study found that there was a differential effect of meta-analyses on the use of the 2 drugs. 相似文献
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Cardiac adverse events are a major cause of complications in noncardiac surgery. The benefit of preventive coronary artery revascularisation in stable patients before noncardiac surgery has recently been clarified: in the short-term there is no reduction in the number of postoperative myocardial infarction, deaths or hospital length of stay. Coronary artery revascularisation should be limited to these patients who have a well-defined need for the procedure, independent of the need of noncardiac surgery. Optimising medical therapy remains the best option for reducing perioperative complications in stable patients: the addition of statin therapy in candidates for noncardiac surgery with known or strongly suspected coronary disease may be conceived. There is compelling evidence for the use of beta-blockers in reducing cardiac risk. This review presents the studies that support the beneficial effect of beta-blockers, pharmacological effects and some practical aspects in noncardiac surgery. In the management of most of these patients, the use of beta-blockers can aid in the avoidance of a preoperative stress test. The remaining problem to solve is the cost-effective identification of the small group of patients in which the protective effect of beta-blocker therapy is insufficient and a cardiac revascularisation should be considered. 相似文献
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The so-called central or upper-body obesity has been shown to play a key role in the development of insulin resistance and lipid abnormalities that commonly are associated with metabolic syndrome. Reducing free fatty acids (FFA) levels improves insulin resistance and lipid profile in metabolic syndrome. The established approach to improving FFA metabolism in obesity is based on inhibition of lipolysis, weight loss and treatment with thiazolidinediones (TZDs). Thiazolidinediones effect on lipids and lipid metabolism will be reviewed, particularly as regard their activity on the abnormal FFA metabolism, related to insulin-resistance. The many questions still unsolved about the molecular mechanisms, the large spectrum of action and the similarities and differences between rosiglitazone and pioglitazone action on lipid metabolism have been reviewed as well as the effect of these new insulin-sensitizers on non conventional cardiovascular risk factors. 相似文献
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2015年,前蛋白转化酶枯草杆菌蛋白酶/kexin 9(proprotein convertase subtilisin kexin 9,PCSK9)抑制剂依洛尤单抗被美国食品药品监督管理局(the Food and Drug Administration,FDA)批准上市,为高脂血症及心血管高危患者的治疗带来了新的希望。本文综述了依洛尤单抗的药学性质及相关临床试验结果,并介绍其在真实世界中的应用效果,以期为临床药物治疗提供参考。 相似文献
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目的:系统评价罗格列酮和吡格列酮对65岁以上糖尿病患者心血管事件的风险。方法:以"罗格列酮","吡格列酮","心血管风险","心血管事件","老年患者","65岁以上",以及"队列研究"为关键词,分别检索Cochrane图书馆(1996—2010年)、PubMed(1966—2010年)、荷兰医学文摘(1966—2010年)、中国期刊全文数据库(1979—2010年)、中国生物医学文献数据库(1978—2010年)和中国科技期刊数据库(1989—2010年)。收集罗格列酮和吡格列酮治疗65岁以上糖尿病患者所致心血管事件风险比较的回顾性队列研究的文献。根据纳入标准对文献进行筛选和评估,采用RevMan 5.0软件对数据进行meta分析,计算65岁以上糖尿病患者应用罗格列酮或吡格列酮后心肌梗死、心力衰竭及全因死亡的相对危险系数(RR)和95%可信区间(CI)。结果:共获得相关文献74篇,经筛选最终纳入2008—2010年3项回顾性队列研究,共有患者295 668例,其中应用罗格列酮患者104 479例,应用吡格列酮患者191 189例。meta分析结果显示,与应用吡格列酮患者相比,应用罗格列酮患者心肌梗死、心力衰竭和全因死亡的发生率均高,其RR(95%CI)分别为1.05(0.98~1.13,P=0.17),1.22(1.05~1.40,P=0.007),1.14(1.08~1.21,P<0.000 01)。结论:老年2型糖尿病患者应用罗格列酮治疗,发生心力衰竭及全因死亡的风险较吡格列酮高。 相似文献