Suspected adverse drug reactions of the type 2 antidiabetic drug class dipeptidyl‐peptidase IV inhibitors (DPP4i): Can polypharmacology help explain?

Abstract

To interpret the relationship between the polypharmacology of dipeptidyl‐peptidase IV inhibitors (DPP4i) and their suspected adverse drug reaction (ADR) profiles using a national registry. A retrospective investigation into the suspected ADR profile of four licensed DPP4i in the United Kingdom using the National MHRA Yellow Card Scheme and OpenPrescribing databases. Experimental data from the ChEMBL database alongside physiochemical (PC) and pharmacokinetic (PK) profiles were extracted and interpreted. DPP4i show limited polypharmacology alongside low suspected ADR rates. We found a minimal statistical difference between the unique ADR profiles ascribed to the DPP4i except for total ADRs ( χ 2 ; p < .05). Alogliptin consistently showed the highest suspected ADR rate per 1 000 000 items prescribed. Saxagliptin showed the lowest suspected ADR rate across all organ classes but did not reach statistical difference ( χ 2 ; p > .05). We confirmed the Phase III clinical trial data that showed gastrointestinal and skin reactions are the most reported ADRs across the DPP4i class and postulated underlying mechanisms for this based on possible drug interactions. The main pharmacological mechanism behind the ADRs is attributed to interactions with DPP4 activity and/or structure homolog (DASH) proteins which augment the immune‐inflammatory modulation of DPP4.

The Relationship Between Suspected Adverse Drug Reactions Of HMG-Coa Reductase Inhibitors And Polypharmacology Using A National Registry Approach

“…[13][14] We herein report an approach to identifying patterns between the statin structures, their unique pharmacology and suspected ADR signals. [15][16][17][18][19]…”

Inhibitory effects of selected cannabinoids against dipeptidyl peptidase IV, an enzyme linked to type 2 diabetes

“…Commercially available DPP-IV inhibitors include drugs such as linagliptin, vildagliptin, sitagliptin and saxagliptin, which act as reversible competitive inhibitors of the catalytic activity of this enzyme [ 9 ]. Current drugs are known to have a number of side effects, including pancreatitis, nasopharyngitis, hepatic disorders and gastrointestinal symptoms [ 14 , 15 ]. Therefore, research efforts seeking alternative DPP-IV inhibitors that have fewer or no undesirable side effects have increased.…”

A General Method to Access Underexplored Ylideneamino Sulfates as Interrupted Beckmann-Type Rearrangement Intermediates

“…The amide functional group is one of the most important and widely encountered structural units in organic chemistry and biochemistry. The amide bond is commonly found in bioactive drug molecules including valsartan, an angiotensin receptor blocker (ARB) [1]; sitagliptin, an anti-diabetic medicine used to treat type-2 diabetes [2]; olaparib, a PARP inhibitor used to treat BRCA-mutated advanced ovarian cancer [3]; and apixaban, an anti-coagulant used to prevent stroke in nonvalvular atrial fibrillation via the inhibition of Factor Xa (Figure 1) [4].…”