Abstract
BackgroundThe purpose of this study was to evaluate and compare the effects on laboratory parameters among monotherapy with five DPP-4 inhibitors in patients with type 2 diabetes mellitus (DM).MethodsWe identified cohorts of new sitagliptin users (n = 879), vildagliptin users (n = 253), teneligliptin users (n = 260), alogliptin users (n = 237), and linagliptin users (n = 180) in patients with type 2 DM. We used a multivariate regression model to evaluate and compare the effects of the drugs on laboratory parameters including HbA1c concentration and serum concentrations of creatinine, estimated glomerular filtration rate, high density lipoprotein, total cholesterol, triglyceride, aspartate aminotransferase, and alanine aminotransferase among the five DPP-4 inhibitors up to 12 months.ResultsOur study showed a favorable effect on HbA1c concentration and a slightly unfavorable effect on serum creatinine concentration in users of the five DPP-4 inhibitors, a favorable effect on lipid metabolism in sitagliptin, vildagliptin, and alogliptin users, and a favorable effect on hepatic parameters in sitagliptin, alogliptin, and linagliptin users, in comparison of the baseline and exposure periods. However, there was no significant difference in mean change in the concentration of any laboratory parameter among the five groups of DPP-4 inhibitor users.ConclusionsIn this study, we showed the effect of five DPP-4 inhibitors on glycemic, renal, and lipid metabolism, and hepatic parameters. DPP-4 inhibitors are well-tolerated hypoglycemic drugs.
Highlights
The purpose of this study was to evaluate and compare the effects on laboratory parameters among monotherapy with five dipeptidyl-peptidase 4 (DPP-4) inhibitors in patients with type 2 diabetes mellitus (DM)
Teneligliptin is mainly metabolized by cytochrome P450 (CYP) 3A4 and flavin monooxygenases, and approximately 34% is excreted in urine as unchanged compound
We identified 2753 patients with type 2 DM treated with sitagliptin (50 mg/day), 1442 with vildagliptin (100 mg/day), 1170 with teneligliptin (20 mg/day), 796 with alogliptin (25 mg/day), and 445 with linagliptin (5 mg/day)
Summary
The purpose of this study was to evaluate and compare the effects on laboratory parameters among monotherapy with five DPP-4 inhibitors in patients with type 2 diabetes mellitus (DM). Sitagliptin is eliminated via the kidney, and is mainly excreted in urine as unchanged compound. Teneligliptin is mainly metabolized by cytochrome P450 (CYP) 3A4 and flavin monooxygenases, and approximately 34% is excreted in urine as unchanged compound. Teneligliptin is eliminated via dual hepatic and renal routes, and can be used in patients with renal dysfunction without dose adjustment [7]. Alogliptin is mainly excreted in urine as unchanged compound, and 10% of aloglyptin is metabolized by CYP2D6 and CYP3A4 [8]. Linagliptin can be safely used in patients with renal impairment, because, differentiated from other DPP-4 inhibitors, linagliptin is primarily excreted unchanged via an entero-hepatic mechanism [6, 8]
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