Вряд ли кто-то привязывал количество глюкозы в моче к тяжести последствий на 12 пациентах, тем более, что препарат отменялся при появлении признаков инфекции.
Более примечательно увеличение доли женщин с гангреной Фурнье на глифлозинах, а также увеличение общей частоты случаев инфекции в сравнении с другими видами терапии.
Из [
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Цитата:
Overall published literature about the occurrence of Fournier’s gangrene for men and women is very limited. Publications report that Fournier’s gangrene occurs in 1.6 out of 100,000 males annually in the U.S., and most frequently occurs in males 50-79 years (3.3 out of 100,000).1-3 In our case series, however, we observed events in both women and men.
In the five years from March 2013 to May 2018, we identified 12 cases of Fournier’s gangrene in patients taking an SGLT2 inhibitor. This number includes only reports submitted to FDA* and found in the medical literature,4-6 so there may be additional cases about which we are unaware. In 2017, an estimated 1.7 million patients received a dispensed prescription for an SGLT2 inhibitor from U.S. outpatient retail pharmacies.7 Although most cases of Fournier’s gangrene have previously been reported in men, our 12 cases included 7 men and 5 women. Fournier’s gangrene developed within several months of the patients starting an SGLT2 inhibitor and the drug was stopped in most cases. All 12 patients were hospitalized and required surgery. Some patients required multiple disfiguring surgeries, some developed complications, and one patient died. In comparison, only six cases of Fournier’s gangrene (all in men) were identified in review of other antidiabetic drug classes over a period of more than 30 years.
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Опять же, данные относятся к САСШ с поголовной модой на гигиеническое обрезание. Сейчас будут более активно данные накапливать, но пока частота всё равно мала, хотя осложнение весьма серьёзное.