Systematic Literature Review of DPP-4 Inhibitors in Patients with Type 2 Diabetes Mellitus and Renal Impairment

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Thomas , M C , Paldanius , P M , Ayyagari , R , Ong , S H & Groop , P-H 2016 , ' Systematic Literature Review of DPP-4 Inhibitors in Patients with Type 2 Diabetes Mellitus and Renal Impairment ' Diabetes therapy , vol. 7 , no. 3 , pp. 439-454 . DOI: 10.1007/s13300-016-0189-4

Title: Systematic Literature Review of DPP-4 Inhibitors in Patients with Type 2 Diabetes Mellitus and Renal Impairment
Author: Thomas, Merlin C.; Paldanius, Paivi M.; Ayyagari, Rajeev; Ong, Siew Hwa; Groop, Per-Henrik
Contributor: University of Helsinki, Department of Medicine
Date: 2016-09
Language: eng
Number of pages: 16
Belongs to series: Diabetes therapy
ISSN: 1869-6953
URI: http://hdl.handle.net/10138/167526
Abstract: Dipeptidyl peptidase-4 (DPP-4) inhibitors are widely used in the management of patients with type 2 diabetes mellitus (T2DM) and renal impairment (RI). A systematic literature review was performed to compare the efficacy and safety of DPP-4 inhibitors in patients with T2DM and RI. We searched EMBASE, MEDLINE, and the Cochrane Central Register of Controlled Trials (cut-off, June 2015) to identify aeyen12-week, randomized, placebo-controlled trials on DPP-4 inhibitors in aeyen50 patients with T2DM and RI. Outcomes of interest included change in glycated hemoglobin (HbA1c), overall safety, and incidence of hypoglycemic events (HEs). Seven trials of aecurrency sign52-54 weeks duration were retrieved, which included one study each on vildagliptin, saxagliptin, and sitagliptin, two on linagliptin, and the remaining two were extension studies of vildagliptin and saxagliptin. Majority of patients were on insulin at baseline (53-86%), except in the sitagliptin study, where approximately 11% received insulin during the placebo-controlled phase. After 52 weeks, vildagliptin and saxagliptin reduced HbA1c levels by 0.6-0.7% (baseline 7.8-8.4%) versus placebo in the overall population. HbA1c reductions were similar at weeks 12 and 52. In the 12-week, placebo-controlled phase, sitagliptin and linagliptin reduced mean HbA1c by approximately 0.4% (baseline 7.7-8.1%) versus placebo. Rates of HEs with DPP-4 inhibitors were not significantly different versus placebo in any study. Rates of adverse events (AEs) and changes involving renal function were similar in the active- and placebo-treated groups. These results suggest that DPP-4 inhibitors have the potential to improve glycemic control in patients with RI without increasing the risk of HEs or overall AEs. Novartis Pharma AG.
Subject: DPP-4 inhibitors
Linagliptin
Saxagliptin
Sitagliptin
Type 2 diabetes mellitus
Vildagliptin
CHRONIC KIDNEY-DISEASE
QUALITY-OF-LIFE
GLYCEMIC CONTROL
LONG-TERM
SEVERE HYPOGLYCEMIA
BLOOD-PRESSURE
DOUBLE-BLIND
EFFICACY
SAFETY
LINAGLIPTIN
3121 Internal medicine
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