medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2017-3-38-43medsovet-1747Research ArticleСАХАРНЫЙ ДИАБЕТDIABETES MELLITUSЭМПАГЛИФЛОЗИН – НОВОЕ ПОКАЗАНИЕ К ПРИМЕНЕНИЮ – ПОВОРОТНЫЙ МОМЕНТ В ЛЕЧЕНИИ САХАРНОГО ДИАБЕТА 2-го ТИПАA NEW INDICATION FOR EMPAGLIFLOZIN: TURNING POINT IN THE TREATMENT OF TYPE 2 DIABETESАмосоваМ. В.AmosovaM. V.ФадеевВ. В.FadeevV. V.

д.м.н., профессор, чл.-корр. РАН

MD, Prof., Corresponding Member of the RAS

Первый Московский государственный медицинский университет им. И.М. СеченоваРоссияFirst Moscow State Medical University named after I.M. SechenovRussian Federation201730122017033843Copyright © Амосова М.В., Фадеев В.В., 20172017Амосова М.В., Фадеев В.В.Amosova M.V., Fadeev V.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/1747

В современной клинической практике терапия сахарного диабета 2-го типа должна быть направлена не только на достижение контроля гликемии, но и на воздействие на другие модифицированные факторы риска развития сердечно-сосудистых заболеваний, включающие в себя артериальную гипертензию, избыточную массу тела, частые гипогликемии и т. д. [4]. Эмпаглифлозин является первым сахароснижающим препаратом, для которого одобрено новое показание использования как средства, уменьшающего риск сердечно-сосудистой смертности у пациентов с сахарным диабетом 2-го типа и сопутствующими сердечно-сосудистыми заболеваниями.

In today’s clinical practice, the treatment of type 2 diabetes mellitus should be targeted not only at achieving glycemic control, but should also affect other modified risk factors for cardiovascular disease including hypertension, overweight, frequent hypoglycemia, etc. [4] Empagliflozin is the first antidiabetic drug with the new approved indication allowing it to be used for the reduction of cardiovascular mortality risks in patients with type 2 diabetes and comorbid cardiovascular diseases.

сахарный диабет 2-го типасердечно-сосудистые осложненияэмпаглифлозинtype 2 diabetescardiovascular diseasesempagliflozinReferencesАлгоритмы специализированной медицинской помощи больным сахарным диабетом, 7-е изд. Сахарныйдиабет, 2015, 18(1S): 1-112.Алгоритмы специализированной медицинской помощи больным сахарным диабетом, 7-е изд. Сахарныйдиабет, 2015, 18(1S): 1-112.Bloomgarden ZT. Cardiovascular disease in diabetes. Diabetes Care, 2008, 31(6): 1260-66.Bloomgarden ZT. Cardiovascular disease in diabetes. Diabetes Care, 2008, 31(6): 1260-66.Boucher JL, Hurrell DG. Cardiovascular Disease and Diabetes. Diabetes Spectrum, 2008, 21(3): 154-55.Boucher JL, Hurrell DG. Cardiovascular Disease and Diabetes. Diabetes Spectrum, 2008, 21(3): 154-55.Gaede P, Vedel P, Larsen N, Jensen GV, Parving HH, Pedersen O. Multifactorial intervention and cardiovascular disease in patients with type 2 diabetes. N. Engl. J. Med., 2003, 348(5): 383-93.Gaede P, Vedel P, Larsen N, Jensen GV, Parving HH, Pedersen O. Multifactorial intervention and cardiovascular disease in patients with type 2 diabetes. N. Engl. J. Med., 2003, 348(5): 383-93.Emdin CA, Rahimi K, Neal B, Callender T, Perkovic V, Patel A. Blood pressure lowering in type 2 diabetes: a systematic review and metaanalysis. JAMA, 2015, 313: 603.Emdin CA, Rahimi K, Neal B, Callender T, Perkovic V, Patel A. Blood pressure lowering in type 2 diabetes: a systematic review and metaanalysis. JAMA, 2015, 313: 603.Zoungas S, Chalmers J, Neal B et al. Follow- up of blood-pressure lowering and glucose control in type 2 diabetes. N. Engl. J. Med., 2014, 371: 1392.Zoungas S, Chalmers J, Neal B et al. Follow- up of blood-pressure lowering and glucose control in type 2 diabetes. N. Engl. J. Med., 2014, 371: 1392.Law MR, Morris JK, Wald NJ. Use of blood pressure lowering drugs in the prevention of cardiovascular disease: meta-analysis of 147 randomised trials in the context of expectations from prospective epidemiological studies. BMJ, 2009, 338.Law MR, Morris JK, Wald NJ. Use of blood pressure lowering drugs in the prevention of cardiovascular disease: meta-analysis of 147 randomised trials in the context of expectations from prospective epidemiological studies. BMJ, 2009, 338.Gerich JE. Role of the kidney in normal glucose homeostasis and in the hyperglycaemia of diabetes mellitus: Therapeutic implications. Diabetic Medicine, 2010, 27(2): 136-42.Gerich JE. Role of the kidney in normal glucose homeostasis and in the hyperglycaemia of diabetes mellitus: Therapeutic implications. Diabetic Medicine, 2010, 27(2): 136-42.Wright EM, Loo DD, Hirayama BA. Biology of human sodium glucose transporters. Physiol. Rev., 2011, 91(2): 733–94.Wright EM, Loo DD, Hirayama BA. Biology of human sodium glucose transporters. Physiol. Rev., 2011, 91(2): 733–94.Hummel CS, Lu C, Loo DDF, Hirayama BA, Voss AA, Wright EM. Glucose transport by human renal Na+/D-glucose cotransporters SGLT1 and SGLT2. Am. J. Physiol. Cell. Physiol., 2011, 300(1): 14-21.Hummel CS, Lu C, Loo DDF, Hirayama BA, Voss AA, Wright EM. Glucose transport by human renal Na+/D-glucose cotransporters SGLT1 and SGLT2. Am. J. Physiol. Cell. Physiol., 2011, 300(1): 14-21.Grempler R, Thomas L, Eckhardt M, Himmelsbach F, Sauer A, Sharp DE et al. Empagliflozin, a novel selective sodium glucose cotransporter-2 (SGLT2) inhibitor: characterisation and comparison with other SGLT2 inhibitors. Diabetes Obes. Metab., 2012, 14(1): 650-57.Grempler R, Thomas L, Eckhardt M, Himmelsbach F, Sauer A, Sharp DE et al. Empagliflozin, a novel selective sodium glucose cotransporter-2 (SGLT2) inhibitor: characterisation and comparison with other SGLT2 inhibitors. Diabetes Obes. Metab., 2012, 14(1): 650-57.Инструкция по медицинскому применению лекарственного препарата Джардинс. Регистрационное удостоверение ЛП-002735 от 2015.Инструкция по медицинскому применению лекарственного препарата Джардинс. Регистрационное удостоверение ЛП-002735 от 2015.Chilton R, Tikkanen I, Cannon CP, Crowe S, Woerle HJ, Broedl UC, Johansen OE. Effects of empagliflozin on blood pressure and markers of arterial stiffness and vascular resistance in patients with type 2 diabetes. Diabetes Obes. Metab, 2015, 17: 1180-93.Chilton R, Tikkanen I, Cannon CP, Crowe S, Woerle HJ, Broedl UC, Johansen OE. Effects of empagliflozin on blood pressure and markers of arterial stiffness and vascular resistance in patients with type 2 diabetes. Diabetes Obes. Metab, 2015, 17: 1180-93.Bailey CJ. The challenge of managing coexistent type 2 diabetes and obesity. BMJ, 2011, 342: d1996.Bailey CJ. The challenge of managing coexistent type 2 diabetes and obesity. BMJ, 2011, 342: d1996.Aronne LJ, Segal RK. Adiposity and fat distribution outcome measures: assessment and clinial implications. Obes. Res., 2002, 10(1): 14-21.Aronne LJ, Segal RK. Adiposity and fat distribution outcome measures: assessment and clinial implications. Obes. Res., 2002, 10(1): 14-21.Kovacs CS, Seshiah V, Swallow R, Jones R, Rattunde H, Woerle HJ, Broedl UC. Empagliflozin improves glycaemic and weight control as add-on therapy to pioglitazone or pioglitazone plus metformin in patients with type 2 diabetes: a 24-week, randomized, placebo-controlled trial. Diabetes Obes. Metab., 2014, 16(2): 147-58.Kovacs CS, Seshiah V, Swallow R, Jones R, Rattunde H, Woerle HJ, Broedl UC. Empagliflozin improves glycaemic and weight control as add-on therapy to pioglitazone or pioglitazone plus metformin in patients with type 2 diabetes: a 24-week, randomized, placebo-controlled trial. Diabetes Obes. Metab., 2014, 16(2): 147-58.Zinman B, Wanner C, Lachin JM, Fitchett D, Bluhmki E, Hantel S, Mattheus M, Devins T, Johansen OE, Woerle HJ, Broedl UC, Inzucchi SE. Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes. N. Engl. J. Med., 2015, 373(22): 2117-28.Zinman B, Wanner C, Lachin JM, Fitchett D, Bluhmki E, Hantel S, Mattheus M, Devins T, Johansen OE, Woerle HJ, Broedl UC, Inzucchi SE. Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes. N. Engl. J. Med., 2015, 373(22): 2117-28.Handelsman Y, DeFronzo RA, Grunberger G, Umpierrez GE. American association of clinical endocrinologists and american college of endocrinology position statement on the association of SGLT-2 inhibitors and diabetic ketoacidosis. Diabetes Care, 2017 January, 40(Supplement 1).Handelsman Y, DeFronzo RA, Grunberger G, Umpierrez GE. American association of clinical endocrinologists and american college of endocrinology position statement on the association of SGLT-2 inhibitors and diabetic ketoacidosis. Diabetes Care, 2017 January, 40(Supplement 1).Trial Investigators ORIGIN, Gerstein HC, Bosch J, Dagenais GR, Díaz R, Jung H, Maggioni AP, Pogue J, Probstfield J, Ramachandran A, Riddle MC, Rydén LE, Yusuf S. Basal insulin and cardiovascular and other outcomes in dysglycemia. N. Engl. J. Med., 2012, 367: 319-28.Trial Investigators ORIGIN, Gerstein HC, Bosch J, Dagenais GR, Díaz R, Jung H, Maggioni AP, Pogue J, Probstfield J, Ramachandran A, Riddle MC, Rydén LE, Yusuf S. Basal insulin and cardiovascular and other outcomes in dysglycemia. N. Engl. J. Med., 2012, 367: 319-28.Scirica BM, Bhatt DL, Braunwald E, Steg PG, Davidson J, Hirshberg B, et al. Saxagliptin and cardiovascular outcomes in patients with type 2 diabetes mellitus. N. Engl. J. Med., 2013, 369: 1317-26.Scirica BM, Bhatt DL, Braunwald E, Steg PG, Davidson J, Hirshberg B, et al. Saxagliptin and cardiovascular outcomes in patients with type 2 diabetes mellitus. N. Engl. J. Med., 2013, 369: 1317-26.White WB, Cannon CP, Heller SR, Nissen SE, Bergenstal RM, Bakris GL et al. Alogliptin after acute coronary syndrome in patients with type 2 diabetes. N. Engl. J. Med., 2013, 369: 1327-35.White WB, Cannon CP, Heller SR, Nissen SE, Bergenstal RM, Bakris GL et al. Alogliptin after acute coronary syndrome in patients with type 2 diabetes. N. Engl. J. Med., 2013, 369: 1327-35.Green JB, Bethel MA, Armstrong PW, Buse JB, Engel SS, Garg J, et al. Effect of sitagliptin on cardiovascular outcomes in type 2 diabetes. N. Engl. J. Med., 2015, 373: 232-42.Green JB, Bethel MA, Armstrong PW, Buse JB, Engel SS, Garg J, et al. Effect of sitagliptin on cardiovascular outcomes in type 2 diabetes. N. Engl. J. Med., 2015, 373: 232-42.Pfeffer MA, Claggett B, Diaz R, Dickstein K, Gerstein HC, Køber LV, et al. Lixisenatide in patients with type 2 diabetes and acute coronary syndrome. N. Engl. J. Med., 2015, 373: 2247-57.Pfeffer MA, Claggett B, Diaz R, Dickstein K, Gerstein HC, Køber LV, et al. Lixisenatide in patients with type 2 diabetes and acute coronary syndrome. N. Engl. J. Med., 2015, 373: 2247-57.Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JG, Coats AJ et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J, 2016, 37(27): 2129-200. doi: 10.1093/eurheartj/ehw128.Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JG, Coats AJ et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J, 2016, 37(27): 2129-200. doi: 10.1093/eurheartj/ehw128.1499–2671 © 2016 Canadian Diabetes Association. http://dx.doi.org/10.1016/j.jcjd.2016.02.0061499–2671 © 2016 Canadian Diabetes Association. http://dx.doi.org/10.1016/j.jcjd.2016.02.006

The authors declare that there are no conflicts of interest present.