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Repaglinid

Klassificering: A

Preparat: NovoNorm®, Repaglinid Actavis, Repaglinid Arrow, Repaglinid Sandoz, Repaglinid STADA, Repaglinide Accord, Repaglinide Krka, Repaglinide Teva

ATC kod: A10BX02

Substanser: repaglinid

Sammanfattning

Inga kliniskt viktiga könsrelaterade skillnader i effekt av repaglinid har beskrivits. Biverkningsprofilen har i en retrospektiv kohortstudie visat på en ökad risk för kvinnor att behöva vårdas på sjukhus för hjärtsvikt.
Vissa studier indikerar att kvinnor har högre risk att få hypoglykemi vid antidiabetikabehandling än män.

Additional information

Pharmacokinetics and dosing

No studies with a clinically relevant sex analysis regarding the pharmacokinetics of repaglinide have been found.

Effects

No studies with a clinically relevant sex analysis regarding the effect of repaglinide have been found.

Adverse effects

In a retrospective cohort study from Taiwan including patients with type 2 diabetes treated with glinide (meglitinide/repaglinide) (14,357 men, 11,281 women) a higher risk of hospitalized heart failure was found for women (men: adjusted HR 1.26; 95%CI 0.95-1.68; women: adjusted HR 1.88; 95%CI 1.39-2.55) [6].The ACCORD study (Action to Control Cardiovascular Risk in Diabetes) was a randomized, controlled trial designed to test the effect of intensive glucose control compared with standard control on cardiovascular outcomes in patients with type 2 diabetes. The study showed that women had a higher risk of hypoglycemia than men regardless of treatment [1].Analyses of other insulins have shown a higher risk for women to have hypoglycemic events [7-11].

Reproductive health issues

Oral contraceptives may reduce the hypoglycaemic effect of repaglinide [12]. Regarding drug-drug interactions aspects, please consult Janusmed Interactions (in Swedish, Janusmed interaktioner).

Regarding teratogenic aspects, please consult Janusmed Drugs and Birth Defects (in Swedish, Janusmed fosterpåverkan).

Other information

Two observational studies from the 1990’s (43 men, 374 women) reported intentional insulin omission among 1/3 of women to control their weight [2,3].

In a retrospective study in 124 women, peri-menstrual changes in self-reported glucose concentrations were found in 61%. Use of oral contraceptives did not diminish variability in blood glucose [4]. In another study based on questionnaires (406 women) 67% of the participants reported changes in blood glucose levels or glycosuria pre-menstrually and 70% during the menstrual phase. Those with more cravings had larger elevations in blood glucose levels suggesting that giving in to cravings might cause the changes [5].

Försäljning på recept

Fler män än kvinnor hämtade ut tabletter innehållande repaglinid (ATC-kod A10BX02) på recept i Sverige år 2019, totalt 8 269 män och 5 906 kvinnor. Det motsvarar 1,6 respektive 1,2 personer per tusen invånare. Andelen som hämtat ut läkemedel var högst i åldersgruppen 75 år och äldre hos båda könen. I genomsnitt var tabletter innehållande repaglinid 1,5 gånger vanligare hos män [13].

Uppdaterat: 2020-03-20

Litteratursökningsdatum: 2020-03-03

Referenser

  1. Miller ME, Bonds DE, Gerstein HC, Seaquist ER, Bergenstal RM, Calles-Escandon J et al. The effects of baseline characteristics, glycaemia treatment approach, and glycated haemoglobin concentration on the risk of severe hypoglycaemia: post hoc epidemiological analysis of the ACCORD study. BMJ. 2010;340:b5444. PubMed
  2. Polonsky WH, Anderson BJ, Lohrer PA, Aponte JE, Jacobson AM, Cole CF. Insulin omission in women with IDDM. Diabetes Care. 1994;17:1178-85. PubMed
  3. Bryden KS, Neil A, Mayou RA, Peveler RC, Fairburn CG, Dunger DB. Eating habits, body weight, and insulin misuse A longitudinal study of teenagers and young adults with type 1 diabetes. Diabetes Care. 1999;22:1956-60. PubMed
  4. Lunt H, Brown LJ. Self-reported changes in capillary glucose and insulin requirements during the menstrual cycle. Diabet Med. 1996;13:525-30. PubMed
  5. Cawood EH, Bancroft J, Steel JM. Perimenstrual symptoms in women with diabetes mellitus and the relationship to diabetic control. Diabet Med. 1993;10:444-8. PubMed
  6. Lee YC, Chang CH, Dong YH, Lin JW, Wu LC, Hwang JS et al. Comparing the risks of hospitalized heart failure associated with glinide, sulfonylurea, and acarbose use in type 2 diabetes: A nationwide study. Int J Cardiol. 2017;228:1007-1014. PubMed
  7. Seufert J, Brath H, Pscherer S, Borck A, Bramlage P, Siegmund T. Composite efficacy parameters and predictors of hypoglycaemia in basal-plus insulin therapy--a combined analysis of 713 type 2 diabetic patients. Diabetes Obes Metab. 2014;16:248-54. PubMed
  8. Kautzky-Willer A, Kosi L, Lin J, Mihaljevic R. Gender-based differences in glycaemic control and hypoglycaemia prevalence in patients with type 2 diabetes: results from patient-level pooled data of six randomized controlled trials. Diabetes Obes Metab. 2015;17:533-40. PubMed
  9. McGill JB, Vlajnic A, Knutsen PG, Recklein C, Rimler M, Fisher SJ. Effect of gender on treatment outcomes in type 2 diabetes mellitus. Diabetes Res Clin Pract. 2013;102:167-74. PubMed
  10. Owens DR, Bolli GB, Charbonnel B, Haak T, Landgraf W, Porcellati F et al. Effects of age, gender, and body mass index on efficacy and hypoglycaemia outcomes across treat-to-target trials with insulin glargine 100 U/mL added to oral antidiabetes agents in type 2 diabetes. Diabetes Obes Metab. 2017;19:1546-1554. PubMed
  11. Vlckova V, Cornelius V, Kasliwal R, Wilton L, Shakir SA. Hypoglycaemia with oral antidiabetic drugs: results from prescription-event monitoring cohorts of rosiglitazone, pioglitazone, nateglinide and repaglinide. Drug Saf. 2009;32(5):409-18. PubMed
  12. NovoNorm (repaglinide). Summary of Product Characteristics. European Medicines Agency (EMA) [updated 2017-09-28, cited 2020-03-03].
  13. Läkemedelsstatistik. Stockholm: Socialstyrelsen. 2019 [cited 2020-03-10.] länk

Författare: Emelie Elfving, Linnéa Karlsson Lind

Faktagranskat av: Mia von Euler, Carl-Olav Stiller

Godkänt av: Karin Schenck-Gustafsson