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Evidence-based and tailored medication in type 2 diabetes: a pathway learned from clinical trials
In Japan, the choice of anti-diabetic medication is officially recommended according to the patient’s glycemic condition and disease phenotype, unlike most other regions where metformin is recommended as the first-line medication. There has been an increase in the number of available glucose-lowerin...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6394044/ https://www.ncbi.nlm.nih.gov/pubmed/30819188 http://dx.doi.org/10.1186/s12933-019-0834-0 |
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author | Tanaka, Atsushi Node, Koichi |
author_facet | Tanaka, Atsushi Node, Koichi |
author_sort | Tanaka, Atsushi |
collection | PubMed |
description | In Japan, the choice of anti-diabetic medication is officially recommended according to the patient’s glycemic condition and disease phenotype, unlike most other regions where metformin is recommended as the first-line medication. There has been an increase in the number of available glucose-lowering agents, making it necessary to select these agents based on ever-improving evidence obtained from clinical trials. For the dipeptidyl peptidase-4 inhibitor class of drugs, nine drugs are currently available on the market in Japan. Although previous cardiovascular outcome trials (CVOTs) demonstrated non-inferiority for both major adverse cardiovascular events (MACEs) and safety for some drugs of the class, the design and results of the CARMELINA trial seemed to be slightly different from earlier trials in that it showed the drugs were safe and partially effective even in patients with renal impairment. Thus, recent CVOTs on newer glucose-lowering agents have mainly focused on the major impacts of individual classes and drugs on clinical outcomes behind their glucose-lowering action. The diverse features of the classes and individual drugs may have also highlighted not only the class-effects, but also the drug-effects of glucose-lowering agents. This will lead to clinical-based evidence and assist with optimum selection of the class and/or drug for tailored medication in patients with type 2 diabetes. |
format | Online Article Text |
id | pubmed-6394044 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-63940442019-03-11 Evidence-based and tailored medication in type 2 diabetes: a pathway learned from clinical trials Tanaka, Atsushi Node, Koichi Cardiovasc Diabetol Commentary In Japan, the choice of anti-diabetic medication is officially recommended according to the patient’s glycemic condition and disease phenotype, unlike most other regions where metformin is recommended as the first-line medication. There has been an increase in the number of available glucose-lowering agents, making it necessary to select these agents based on ever-improving evidence obtained from clinical trials. For the dipeptidyl peptidase-4 inhibitor class of drugs, nine drugs are currently available on the market in Japan. Although previous cardiovascular outcome trials (CVOTs) demonstrated non-inferiority for both major adverse cardiovascular events (MACEs) and safety for some drugs of the class, the design and results of the CARMELINA trial seemed to be slightly different from earlier trials in that it showed the drugs were safe and partially effective even in patients with renal impairment. Thus, recent CVOTs on newer glucose-lowering agents have mainly focused on the major impacts of individual classes and drugs on clinical outcomes behind their glucose-lowering action. The diverse features of the classes and individual drugs may have also highlighted not only the class-effects, but also the drug-effects of glucose-lowering agents. This will lead to clinical-based evidence and assist with optimum selection of the class and/or drug for tailored medication in patients with type 2 diabetes. BioMed Central 2019-02-28 /pmc/articles/PMC6394044/ /pubmed/30819188 http://dx.doi.org/10.1186/s12933-019-0834-0 Text en © The Author(s) 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Commentary Tanaka, Atsushi Node, Koichi Evidence-based and tailored medication in type 2 diabetes: a pathway learned from clinical trials |
title | Evidence-based and tailored medication in type 2 diabetes: a pathway learned from clinical trials |
title_full | Evidence-based and tailored medication in type 2 diabetes: a pathway learned from clinical trials |
title_fullStr | Evidence-based and tailored medication in type 2 diabetes: a pathway learned from clinical trials |
title_full_unstemmed | Evidence-based and tailored medication in type 2 diabetes: a pathway learned from clinical trials |
title_short | Evidence-based and tailored medication in type 2 diabetes: a pathway learned from clinical trials |
title_sort | evidence-based and tailored medication in type 2 diabetes: a pathway learned from clinical trials |
topic | Commentary |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6394044/ https://www.ncbi.nlm.nih.gov/pubmed/30819188 http://dx.doi.org/10.1186/s12933-019-0834-0 |
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