Use of Canephron ® N for symptoms of acute cystitis in female patients with type 2 diabetes mellitus taking sodium-glucose cotransporter-2 inhibitors


DOI: https://dx.doi.org/10.18565/therapy.2023.8.152-161

Malyavin A.G., Gubernatorova E.E., Babak S.L.

A.I. Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of Russia
Abstract. Diabetes mellitus (DM) is associated with an increased risk of urinary tract infections (UTIs) developing.
The aim: to evaluate the effect of Canephron® N medicine at dysuric symptoms severity, probability of refusing from sodium-glucose cotransporter type 2 inhibitors (SGLT-2 inhibitors) therapy and life quality of female patients with type 2 diabetes (T2DM) taking drugs of this class and having symptoms of dysuria.
Material and methods. The study included 40 female patients with symptoms of cystitis having >6 points on the questionnaire scale (ACSS) in addition to type 2 diabetes and taking SGLT-2. In the main group (n=20), in addition to standard therapy, patients received Canephron® N for 1 month, 2 tablets 3 times a day. In the comparison group (n=20), participants of yhe study received standard treatment for cystitis. At the 1st (day 0), 2nd (day 30), and 3rd (day 90) visits, common urine analysis and the ACSS questionnaire completing were performed. At the 1st and 3rd visits, the SF-36 quality of life questionnaire was completed and the level of glycated hemoglobin was examined.
Results. In comparison group, 3 (15%) patients stopped taking SGLT-2 inhibitors because they associated dysuria with these drugs intake. In the main group there was no refusal to continue using SGLT-2. There were recorded no adverse events in both groups. In the main group and the comparison group, a statistically significant decrease in the ACSS score was revealed at the 2nd and 3rd visits (p=0,006 and p <0,001, respectively). At the 3rd visit, a statistically significant decrease in leukocyturia was found in the main group (p=0,020). Also in the main group there was a statistically significant increase in the score of physical functioning due to physical condition (p=0,009), vital activity (p=0,036) and level of social functioning (p=0,044).
Conclusion. The data of the study confirm the reasonability of adding Canephron® N medicine to the treatment regimens of female patients with acute cystitis symptoms in addition to type 2 diabetes mellitus, taking SGLT-2. One can note a decrease in clinical symptoms, leukocyturia and an improvement in the life quality of patients during therapy with Canephron® N and a decrease of the probability of refusing from SGLT-2 drugs therapy.

Literature


1. Muller L.M., Gorter K.J., Hak E. et al. Increased risk of common infections in patients with type 1 and type 2 diabetes mellitus. Clin Infect Dis. 2005; 41(3): 281–88. https://dx.doi.org/10.1086/431587.


2. De Lastours V., Foxman B. Urinary tract infection in diabetes: epidemiologic considerations. Curr Infect Dis Rep. 2014; 16(1): 389. https://dx.doi.org/10.1007/s11908-013-0389-2.


3. Hirji I., Andersson S.W., Guo Z. et al. Incidence of genital infection among patients with type 2 diabetes in the UK General Practice Research Database. J Diabetes Complications. 2012; 26(6): 501–5. https://dx.doi.org/10.1016/j.jdiacomp.2012.06.012.


4. Turan H., Serefhanoglu K., Torun A.N. et al. Frequency, risk factors, and responsible pathogenic microorganisms of asymptomatic bacteriuria in patients with type 2 diabetes mellitus. Jpn J Infect Dis. 2008; 61(3): 236–38.


5. Geerlings S.E., Meiland R., van Lith E.C. et al. Adherence of type 1-fimbriated Escherichia coli to uroepithelial cells: More in diabetic women than in control subjects. Diabetes Care. 2002; 25(8): 1405–9. https://dx.doi.org/10.2337/diacare.25.8.1405.


6. Wu X.R., Sun T.T., Medina J.J. In vitro binding of type 1-fimbriated Escherichia coli to uroplakins Ia and Ib: Relation to urinary tract infections. Proc Natl Acad Sci U S A. 1996; 93(18): 9630–35. https://dx.doi.org/10.1073/pnas.93.18.9630.


7. Delamaire M., Maugendre D., Moreno M. et al. Impaired leucocyte functions in diabetic patients. Diabet Med. 1997; 14(1): 29–34. https://dx.doi.org/10.1002/(SICI)1096-9136(199701)14:1<29::AID-DIA300>3.0.CO;2-V.


8. Geerlings S.E., Brouwer E.C., van Kessel K.P. et al. Cytokine secretion is impaired in women with diabetes mellitus. Adv Exp Med Biol. 2000; 485: 255–62. https://dx.doi.org/10.1007/0-306-46840-9_34.


9. Arakaki R.F. Sodium-glucose cotransporter-2 inhibitors and genital and urinary tract infections in type 2 diabetes. Postgrad Med. 2016; 128(4): 409–17. https://dx.doi.org/10.1080/00325481.2016.1167570.


10. Vallon V., Verma S. Effects of SGLT2 inhibitors on kidney and cardiovascular function. Annu Rev Physiol. 2021: 83: 503–28. https://dx.doi.org/10.1146/annurev-physiol-031620-095920.


11. McGill JB, Subramanian S. Safety of Sodium-Glucose Co-Transporter 2 Inhibitors. Am J Cardiol. 2019 Dec 15;124 Suppl 1:S45-S52. doi: 10.1016/j.amjcard.2019.10.029. PMID: 31741440.


12. Мартынюк Л. и др. Влияние растительного препарата Канефрон® H на течение диабетической нефропатии у пациентов с сахарным диабетом 2-го типа: результаты сравнительного когортного исследования //Почки. – 2015. – №. 1 (11). – С. 24-32.


13. Gaybullaev A. A., Kariev S. S. Effects of the herbal combination Canephron® N on urinary risk factors of idiopathic calcium urolithiasis in an open study //Zeitschrift für Phytotherapie. – 2013. – Т. 34. – №. 01. – С. 16-20.


14. Haloui M. et al. Experimental diuretic effects of Rosmarinus officinalis and Centaurium erythraea //Journal of ethnopharmacology. – 2000. – Т. 71. – №. 3. – С. 465-472.


15. Григорян З.Г., Локшин К.Л. Применение препарата Канефрон® Н в урологической практике. РМЖ. 2013; 21(18): 924–929. [Grigoryan Z.G., Lokshin K.L. Use of the drug Canephron® N in urological practice. Russkiy meditsinskiy zhurnal = Russian Medical Journal. 2013; 21(18): 924–929 (In Russ.)]. EDN: QZUTIV .


16. McGill J.B., Subramanian S. Safety of sodium-glucose co-transporter 2 inhibitors. The Am J Cardiol. 2019; 124 Suppl 1: S45–52. https://dx.doi.org/10.1016/j.amjcard.2019.10.029.


About the Autors


Andrey G. Malyavin, MD, professor of the Department of phthisiology and pulmonology of the Faculty of general medicine, A.I. Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of Russia, general director of the Center for Respiratory Medicine, chief freelance pulmonologist of the Ministry of Healthcare of Russia for the Central Federal District, general secretary of the Russian Scientific Medical Society of Internal Medicine (RSMSIM). Address: 107150, Moscow, 39/2 Losinoostrovskaya St.
E-mail: maliavin@mail.ru
ORCID: https://orcid.org/0000-0002-6128-5914
Ekaterina E. Gubernatorova, PhD in Medical Sciences, assistant at the Department of therapy and preventive medicine, A.I. Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of Russia. Address: 127473, Moscow, 20/1 Delegatskaya St.
E-mail: creativone@list.ru
ORCID: https://orcid.org/0009-0009-4149-9497
Sergey L. Babak, MD, professor of the Department of phthisiology and pulmonology of the Faculty of general medicine, A.I. Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of Russia. Address: 107150, Moscow, 39/2 Losinoostrovskaya St.
E-mail: sergbabak@mail.ru
ORCID: https://orcid.org/0000-0002-6571-1220


Similar Articles


Бионика Медиа