Ten-year follow-up of sitagliptin treatment in patients with type 2 diabetes mellitus

Sachiko Hattori

doi:10.1186/s13098-021-00735-3

Abstract

BackgroundEarly and effective intervention with a dipeptidyl peptidase 4 inhibitor (DPP4i) before the development of advanced atherosclerosis in type 2 diabetes mellitus (T2DM) patients without a history of cardiovascular disease (CVD) is reported to increase the chance of significant reductions in not only microvascular disease, but also CVD.MethodThis study aimed to investigate whether sitagliptin is effective and tolerated for glycemic control and whether renoprotective effects and β-cell function are preserved for as long as ten years in Japanese patients with T2DM without a history of CVD.ResultsThe situation is equivalent to improving glycemic control as assessed by hemoglobin A1c both in a sitagliptin group [sitagliptin 50 mg as either monotherapy or combination therapy with other oral glucose-lowering drugs (n = 17)] or a control group [placebo as either monotherapy or combination therapy with other glucose-lowering drugs (n = 9)], while anti-inflammatory effects as assessed by high-sensitivity C-reactive peptide in the sitagliptin group were superior to those in the control group. In the sitagliptin group, mean urinary albumin excretion (measured as urinary albumin-to-creatinine ratio) was markedly decreased, but no changes in estimated glomerular filtration rate were seen throughout the study. Beta-cell function as evaluated by homeostatic model assessment of β-cell function values was reduced at baseline in both groups, improved significantly in the sitagliptin group, and continued unchanged in the control group during the study.ConclusionThese observations suggest that early intervention with sitagliptin in patients with T2DM may have long-lasting renoprotective and islet-protective effects.Trial registration: UMIN Clinical Registry (UMIN000038459). Registered 01 November (retrospectively registered): https://upload.umin.ac.jp/UMIN000038459

Highlights

And effective intervention with a dipeptidyl peptidase 4 inhibitor (DPP4i) before the development of advanced atherosclerosis in type 2 diabetes mellitus (T2DM) patients without a history of cardiovascular disease (CVD) is reported to increase the chance of significant reductions in microvascular disease, and CVD
One year after the launch of sitagliptin in Japan, we reported that sitagliptin reduces albuminuria in patients with T2DM to show that a DPP4i could reduce albuminuria [1]
In one year after the launch of sitagliptin in Japan, we reported that sitagliptin reduced albuminuria without changing estimated glomerular filtration rate (eGFR) in patients with T2DM [1]

Summary

Introduction

And effective intervention with a dipeptidyl peptidase 4 inhibitor (DPP4i) before the development of advanced atherosclerosis in type 2 diabetes mellitus (T2DM) patients without a history of cardiovascular disease (CVD) is reported to increase the chance of significant reductions in microvascular disease, and CVD. Sitagliptin was the first dipeptidyl peptidase 4 inhibitor (DPP4i) to receive marketing approval, and was launched in Japan at the end of 2009. Sitagliptin has been shown to have a favorable therapeutic profile and is safe and effective for the majority of Japanese patients with type 2 diabetes mellitus (T2DM) for more than ten Hattori Diabetol Metab Syndr (2021) 13:117 were preserved for at least ten years in Japanese patients with T2DM

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