Lowering of blood pressure and pulse rate by switching from DPP-4 inhibitor to luseogliflozin in patients with type 2 diabetes complicated with hypertension: A multicenter, prospective, randomized, open-label, parallel-group comparison trial (LUNA study)

Abstract

Sodium-glucose cotransporter-2 inhibitor (SGLT2i) reduces clinic blood pressure (BP), but the effects on BP circadian rhythm remain unclear. The present study aimed to determine the nighttime antihypertensive effect of SGLT2i compared with dipeptidyl peptidase-4 inhibitor (DPP-4i) in patients with type 2 diabetes and hypertension. Materials and Methods: In this randomized, open-label, parallel-group trial, patients treated with DPP-4i were either switched to luseogliflozin 2.5 mg/day (Luseo group; n = 30) or continued DPP-4i (DPP-4i group; n = 26). The patients undertook 24-h ambulatory BP monitoring before and 8 weeks after the group allocation. The primary endpoint was mean change in nighttime systolic BP (SBP).Results: Nighttime SBP, as well as daytime SBP, was significantly reduced in the Luseo group compared with the DPP-4i group (nighttime, À4.0 ± 11.4 vs. 3.6 ± 10.7 mmHg, P = 0.01; day-

Overall Efficacy and Safety of Sodium-Glucose Cotransporter 2 Inhibitor Luseogliflozin Versus Dipeptidyl-Peptidase 4 Inhibitors: Multicenter, Open-Label, Randomized-Controlled Trial (J-SELECT study)

“…Furthermore, studies have shown that both DPP-4is and SGLT2is exhibit a renal protective effect to reduce renal albumin and either improve or ameliorate the decrease in eGFR [ 30 – 32 ]. Administration of luseogliflozin decreased heart rate in Japanese patients with T2DM with higher heart rate [ 33 ], and switching from DPP-4is to luseogliflozin has been shown to decrease nighttime pulse rate [ 34 ]. However, to our knowledge, few studies have investigated and compared the overall efficacy of DPP-4is and SGLT2is.…”

Effects of systolic and diastolic blood pressure rhythm on coronary artery disease in type 2 diabetic patients: a retrospective cross-sectional study

“…Other studies suggested that the timing of medication-taking makes sense [14], while most Chinese patients take antihypertensive drugs in the morning. For antidiabetic agents, a meta-analysis showed that sodium-dependent glucose transporters 2 inhibitors (SGLT2i) reduced 24-hour BP in patients with diabetes and hypertension [29], and when changed from dipeptidyl peptidase-4 inhibitor to SGLT2i, the AR-BP signi cantly reduced [30]. Whether SGLT2i can reduce AR-BP and thus reduce the incidence of CAD in diabetic patients is the task we will undergo in the future.…”