Role of GLP-1 and DPP-4 in diabetic nephropathy and cardiovascular disease

Panchapakesan, Usha; Mather, Amanda; Pollock, Carol

doi:10.1042/cs20120167

Cited by 56 publications

(54 citation statements)

References 99 publications

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“…Several reports suggest that DPP-4 inhibitors have antiinflammatory effects and can improve bone marrow function [45,46]. The possibility of scission protection by DPP-4 with antiinflammatory agents such as BNP/ANP (brain natriuretic peptide/atrial natriuretic peptide) or NPY (neuropeptide), which are substrates of DPP-4, is suggested, and an intracorporeal inflammation condition is therefore thought to be ameliorated by DPP-4 inhibitor [47][48][49][50]. This may explain the improved iron bioavailability.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Saxagliptin versus Mitiglinid in patients with type 2 diabetes and end-stage renal disease

Sakai

Sakai²,

Mugishima

et al. 2017

Ren Replace Ther

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Background: There are very few oral antidiabetic drugs recommended for patients on dialysis. Saxagliptin is known for its potent effect and long duration of action. In this study, we compared the efficacy of Saxagliptin with Mitiglinid for diabetes control and renal anemia in hemodialysis patients with type 2 diabetes mellitus. Methods: We performed a 6-month prospective, open-label, parallel group study of 41 patients with type 2 diabetes mellitus undergoing hemodialysis who took alpha-glucosidase inhibitors or meglitinides and did not use insulin. Saxagliptin and Mitiglinid were administered at 2.5 and 5 mg/day, respectively. The primary outcomes were changes in hemoglobin A1c (HbA1c) and glycated albumin (GA). Other efficacy assessments included changes in Hb, darbepoetin alpha (DA) dose, and erythropoietin responsiveness index (ERI). Results: No patient required an increase in Saxagliptin or Mitiglinid dose, and there were no cases of hypoglycemia with symptoms. HbA1c and GA values were not significantly different between both groups. For HbA1c, the gradient of the regression line of the Saxagliptin and Mitiglinid groups were Y = −7.144e-005*X + 6.023 and Y = −0. 02604*X + 6.292, respectively, and no significant difference was found (p = 0.3281). However, for GA, the regression line of the Saxagliptin group significantly decreased (Y = −0.5036*X + 19.34 and Y = −0.2346*X + 18.79, p = 0.0371). Both groups did not have a significant change in the DA dose through the observation period. However, the DA dose of the Saxagliptin group significantly decreased when we compared the regression lines (Y = −0.8304*X + 21. 06 and Y = 0.6286*X + 16.12, p = 0.0019) of both groups. Furthermore, ERI did not change significantly but showed a significant difference when regression lines were compared (Y = −0.2030*X + 6.654 and Y = 0.1116*X + 5.288, p = 0.0082).

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Section: Discussionmentioning

confidence: 99%

Efficacy of Saxagliptin versus Mitiglinid in patients with type 2 diabetes and end-stage renal disease

Sakai

Sakai²,

Mugishima

et al. 2017

Ren Replace Ther

View full text Add to dashboard Cite

show abstract

“…Among the recently launched diabetes drugs that have achieved marked progress in treatment, oral dipeptidyl peptidase-4 (DPP-4) inhibitors ("DPP-4 inhibitors") carry a lower risk of hypoglycemia and body weight gain (13)(14)(15)(16)(17). Their benefits in protecting the kidneys have been also reported in recent studies (18)(19)(20)(21)(22)(23)(24).…”

Section: Introductionmentioning

confidence: 91%

Effects of Alogliptin in Chronic Kidney Disease Patients with Type 2 Diabetes

et al. 2014

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Objective Diabetes is a major risk factor for chronic kidney disease (CKD). In this study, we examined the effects of alogliptin on blood glucose control and the renal function in type 2 diabetes CKD patients. Methods We recruited 36 CKD patients with type 2 diabetes. The patients were followed up for six months after adding alogliptin. Blood biochemical, urine test and office BP values were obtained six months before and after the start of treatment. Results The mean HbA1c value was not decreased; however, the 1,5-AG values tended to improve (p= 0.1023). The mean eGFR was unchanged. There were no significant changes in the patients with an eGFR of 60 mL/min/1.73 m 2 or more (25 patients) or in the patients with an eGFR less than 60 mL/min/1.73 m 2 (11 patients). A total of 15 patients were identified to have rapidly declining diabetic nephropathy, with an annual reduction in eGFR of 5 mL/min/1.73 m 2 or more. The slope of the regression line for eGFR (-1.296 before starting treatment with alogliptin) was positive, increasing up to 0.08786. The eGFR values appeared to stop decreasing and positively reversed. The urinary albumin-to-creatinine ratio exhibited a downward trend. The effect on the renal function was independent of the levels of blood sugar, blood pressure and lipids. Conclusion We examined the ability of alogliptin to maintain the renal function in patients with CKD complicated by type 2 diabetes. Our study suggests that alogliptin can be safely administered in patients with CKD. However, although we expected alogliptin to demonstrate renal protective effects, were unable to detect statistically significant differences. One reason for this finding is that there are few registered cases.

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“…Liraglutide (3 mg) has been already approved as a general obesity therapy by FDA and EMA. Exenatide has been studied in a number of defined phenotypes of obesity such as Prader-Willi syndrome, hypothalamic obesity, pediatric obesity, olanzapine-induced obesity, and polycystic ovary syndrome [30,31]. GLP-1 RA may also have a role in pre-diabetes, as the proportion of patients with pre-diabetes decreased by 52% following 2 years of treatment with liraglutide in the obesity trial [32].…”

Section: Other Indications For Incretin Therapies Obesitymentioning

confidence: 99%

Future and emerging therapies

Montanya

2016

Handbook of Incretin-Based Therapies in Type 2 Diabetes

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IntroductionThis chapter is focused on investigational drugs, new methods of administration, and potential new indications of glucagon-like peptide-1 (GLP-1)-based therapies. [3][4][5][6][7][8]. An increase in heart rate has been consistently found in the 1-3 beats/minute range [3,5,7,8]. Increased levels of total amylases, pancreatic amylases, and lipases have been found with both doses of dulaglutide in the trials. For dulaglutide 1.5 mg, the increase in total and pancreatic amylases was higher than with sitagliptin (AWARD-5) Once-weekly agents under investigation

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Role of GLP-1 and DPP-4 in diabetic nephropathy and cardiovascular disease

Cited by 56 publications

References 99 publications

Efficacy of Saxagliptin versus Mitiglinid in patients with type 2 diabetes and end-stage renal disease

Efficacy of Saxagliptin versus Mitiglinid in patients with type 2 diabetes and end-stage renal disease

Effects of Alogliptin in Chronic Kidney Disease Patients with Type 2 Diabetes

Future and emerging therapies

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