신기능에 따른 Sitagliptin의 처방용량 적정성 평가 = Drug Use Evaluation of Sitagliptin Renal Dosing

다국어 초록 (Multilingual Abstract)

Sitagliptin is a new oral medication that meant to lower glucose levels via the incretin hormone system. It is recommended for initial and maintenance dosing at 100 mg daily. Downward dose adjustment is recommended in patients with moderate or severe renal failure. The aim of this study was to determine the prevalence of the potentially inappropriate initial dosing of sitagliptin based on estimated glomerular filtration rate (eGFR) at a teaching hospital. A retrospective analysis using data from an electronic medical record database was performed. Patients were included (n=126), if they were prescribed sitagliptin three times consecutively between February 2010 and August 2010. The variables of interest were (a) the initial sitagliptin dose; and (b) the eGFR, calculated for each patient using the Cockcroft-Gault formula at the time that sitagliptin was prescribed. Fifteen (11.9%) of the 126 patients received a potentially inappropriate initial dose according to product labeling regarding renal function: eleven patients were over-dosed and four patients were under-dosed. Potentially inappropriate dosing occurred in four of 114 patients with mild renal failure (4%); six of seven patients with moderate renal failure (85.7%), and five of five patients with severe renal failure (100%).
In conclusion, potentially inappropriate dosing of sitagliptin based on the assessment of renal function was likely to occur. Further study of the long-term safety of sitagliptin in patients not suffering from renal failure may be warranted.

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