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Dipeptidyl peptidase-4 inhibitor Drug class

Chien-Yi Hsu, Yu-Wen Su, Yung-Tai Chen, Shih-Hung Tsai, Chun-Chin Chang, Szu-Yuan Li, Po-Hsun Huang, Jaw-Wen Chen, Shing-Jong Lin
BACKGROUND: Pleiotropic effects on cardiovascular protection have been suggested in several oral antidiabetic drugs (OAD). The impacts of OADs on aortic aneurysm (AA) growth have been found in animal studies, but the evidence of their beneficial effects for AA protection in human are lacking. We investigated the relationship between OAD therapy and the risk of developing AA. METHODS: We conducted a nested case-control analysis using the database extracted from Taiwan's National Health Insurance Research Database...
2016: Cardiovascular Diabetology
Nobumasa Ohara, Masanori Kaneko, Kazuhiro Sato, Ryoko Maruyama, Tomoyasu Furukawa, Junta Tanaka, Kenzo Kaneko, Kyuzi Kamoi
BACKGROUND: Dipeptidyl peptidase-4 inhibitors are a class of oral hypoglycemic drugs and are used widely to treat type 2 diabetes mellitus in many countries. Adverse effects include nasopharyngitis, headache, elevated serum pancreatic enzymes, and gastrointestinal symptoms. In addition, a few cases of interstitial pneumonia associated with their use have been reported in the Japanese literature. Here we describe a patient who developed drug-induced acute lung injury shortly after the administration of the dipeptidyl peptidase-4 inhibitor vildagliptin...
2016: Journal of Medical Case Reports
Eun Ju Bae
Dipeptidyl peptidase-4 (DPP-4) inhibitors (gliptins) are an emerging class of antidiabetic drugs that constitutes approximately fifty percent of the market share of the oral hypoglycemic drugs. Its mechanism of action for lowering blood glucose is essentially via inhibition of the rapid degradation of incretin hormones, such as glucagon-like peptide (GLP)-1 and gastric inhibitory polypeptide (GIP), thus the plasma concentration of GLP-1 increases, which promotes insulin secretion from the pancreatic β cells and suppresses glucagon secretion from the α cells...
August 2016: Archives of Pharmacal Research
William B White, Craig A Wilson, George L Bakris, Richard M Bergenstal, Christopher P Cannon, William C Cushman, Simon K Heller, Cyrus R Mehta, Steven E Nissen, Faiez Zannad, Stuart Kupfer
Activation of the sympathetic nervous system when there is dipeptidyl peptidase 4 inhibition in the presence of high-dose angiotensin-converting enzyme (ACE) inhibition has led to concerns of potential increases in cardiovascular events when the 2 classes of drugs are coadministered. We evaluated cardiovascular outcomes from the EXAMINE (Examination of Cardiovascular Outcomes With Alogliptin versus Standard of Care) trial according to ACE inhibitor use. Patients with type 2 diabetes mellitus and a recent acute coronary syndrome were randomly assigned to receive the dipeptidyl peptidase 4 inhibitor alogliptin or placebo added to existing antihyperglycemic and cardiovascular prophylactic therapies...
September 2016: Hypertension
Laurent Azoulay, Kristian B Filion, Robert W Platt, Matthew Dahl, Colin R Dormuth, Kristin K Clemens, Madeleine Durand, Nianping Hu, David N Juurlink, J Michael Paterson, Laura E Targownik, Tanvir C Turin, Pierre Ernst, Samy Suissa, Colin R Dormuth, Brenda R Hemmelgarn, Gary F Teare, Patricia Caetano, Dan Chateau, David A Henry, J Michael Paterson, Jacques LeLorier, Adrian R Levy, Pierre Ernst, Robert W Platt, Ingrid S Sketris
Importance: The association between incretin-based drugs, such as dipeptidyl peptidase 4 (DPP-4) inhibitors and glucagon-like peptide 1 (GLP-1) agonists, and acute pancreatitis is controversial. Objective: To determine whether the use of incretin-based drugs, compared with the use of 2 or more other oral antidiabetic drugs, is associated with an increased risk of acute pancreatitis. Design, Setting, and Participants: A large, international, multicenter, population-based cohort study was conducted using combined health records from 7 participating sites in Canada, the United States, and the United Kingdom...
October 1, 2016: JAMA Internal Medicine
Seung-Hyun Ko, Dae-Jung Kim, Jong-Heon Park, Cheol-Young Park, Chang Hee Jung, Hyuk-Sang Kwon, Joong-Yeol Park, Kee-Ho Song, Kyungdo Han, Ki-Up Lee, Kyung-Soo Ko
This study investigated trends in the prescription of antidiabetic medications for patients with type 2 diabetes, focusing on changing patterns of prescriptions and the cost of drugs during the last 10 years. Retrospective data on patients with type 2 diabetes aged 30 years or older were analyzed using information from the National Health Information Database collected by the National Health Insurance Service in Korea from January 2002 to December 2013. We identified patients with type 2 diabetes who had at least one service claim in each year during the study period...
July 2016: Medicine (Baltimore)
Chia-Hsuin Chang, Yi-Cheng Chang, Jou-Wei Lin, James L Caffrey, Li-Chiu Wu, Mei-Shu Lai, Lee-Ming Chuang
BACKGROUND: Saxagliptin has been reported to be associated with an increased risk of hospitalization for heart failure (HF). The objective of this study was to test whether the increased risk is drug specific or a class effect for dipeptidyl peptidase-4 (DPP-4) inhibitors. METHODS: Diabetic patients prescribed sitagliptin, saxagliptin, and vildagliptin between 2011 and 2013 were identified from Taiwan's National Health Insurance (NHI) claims database. The outcome of interest was the first hospitalization for HF...
October 1, 2016: International Journal of Cardiology
Melanie Davies, Sudesna Chatterjee, Kamlesh Khunti
Worldwide, an estimated 200 million people have chronic kidney disease (CKD), the most common causes of which include hypertension, arteriosclerosis, and diabetes. Importantly, ~40% of patients with diabetes develop CKD, yet evidence from major multicenter randomized controlled trials shows that intensive blood glucose control through pharmacological intervention can reduce the incidence and progression of CKD. Standard therapies for the treatment of type 2 diabetes include metformin, sulfonylureas, meglitinides, thiazolidinediones, and insulin...
2016: Clinical Pharmacology: Advances and Applications
Abd A Tahrani, Anthony H Barnett, Clifford J Bailey
Type 2 diabetes mellitus (T2DM) is a global epidemic that poses a major challenge to health-care systems. Improving metabolic control to approach normal glycaemia (where practical) greatly benefits long-term prognoses and justifies early, effective, sustained and safety-conscious intervention. Improvements in the understanding of the complex pathogenesis of T2DM have underpinned the development of glucose-lowering therapies with complementary mechanisms of action, which have expanded treatment options and facilitated individualized management strategies...
October 2016: Nature Reviews. Endocrinology
Crystal Man Ying Lee, Mark Woodward, Stephen Colagiuri
AIM: To estimate and compare the results from all randomised trials of triple combinations of anti-diabetes therapies that reported the reduction of glycated haemoglobin (HbA1c) and associated effects on body weight and hypoglycaemia. METHODS: PubMed and the Cochrane Library were searched for trials with at least one study arm on triple therapy and which reported the differences in mean change in HbA1c between two study arms. These were included in a network meta-analysis...
June 2016: Diabetes Research and Clinical Practice
Lisa M Younk, Elizabeth M Lamos, Stephen N Davis
INTRODUCTION: Cardiovascular disease remains the major contributor to morbidity and mortality in diabetes. From the need to reduce cardiovascular risk in diabetes and to ensure that such risk is not exacerbated by drug treatments, governmental regulators and drug manufacturers have focused on clinical trials evaluating cardiovascular outcomes. AREAS COVERED: Findings from mechanistic and clinical trials of biguanides, sulfonylureas, thiazolidinediones, dipeptidyl peptidase-4 (DPP-4) inhibitors, glucagon-like peptide-1 (GLP-1) receptor agonists, and sodium-glucose co-transporter 2 (SGLT-2) inhibitors will be reviewed...
September 2016: Expert Opinion on Drug Safety
Ersilia M DeFilippis, Michael M Givertz
Over the past two decades, therapeutics for diabetes have evolved from drugs with known heart failure risk to classes with potential benefit for patients with heart failure. As many as 25 to 35 % of patients with heart failure carry a diagnosis of type 2 diabetes mellitus. Therefore, newer drug classes including dipeptidyl peptidase 4 (DPP-4) inhibitors, glucagon-like peptide 1 (GIP-1) agonists, and sodium-glucose cotransporter 2 (SGLT-2) inhibitors are being examined for cardiovascular safety as well as their effects on left ventricular function, quality of life, and other measures of disease progression...
June 2016: Current Heart Failure Reports
Vishal Kothari, John A Galdo, Suresh T Mathews
Current literature shows an association of diabetes and secondary complications with chronic inflammation. Evidence of these immunological changes include altered levels of cytokines and chemokines, changes in the numbers and activation states of various leukocyte populations, apoptosis, and fibrosis during diabetes. Therefore, treatment of diabetes and its complications may include pharmacological strategies to reduce inflammation. Apart from anti-inflammatory drugs, various hypoglycemic agents have also been found to reduce inflammation that could contribute to improved outcomes...
2016: Journal of Inflammation Research
Lars Rydén, Bahira Shahim, Linda Mellbin
Cardiovascular disease is a major threat to people with diabetes. Attempts have long been made to lower cardiovascular risk by means of glucose-lowering treatment. Initially, it seemed that was an option, but subsequent trials could not verify the original observations and there was concern that some glucose-lowering drugs can actually cause cardiovascular harm. This led medical product agencies in the United States and Europe to require major outcomes trials before accepting new glucose-lowering drugs. The least requirement was noninferiority compared with existing treatment modalities...
June 2016: Clinical Therapeutics
Charles F Shaefer
In Brief In the past decade, various incretin-based therapies have emerged in clinical practice. These drugs, including dipeptidyl peptidase-4 inhibitors and glucagon-like peptide 1 (GLP-1) receptor agonists lower A1C with weight-neutral or weight-lowering effects and a relatively lower risk of hypoglycemia. This article provides a review of lixisenatide, a once-daily GLP-1 receptor agonist for the treatment of type 2 diabetes.
April 2016: Clinical Diabetes: a Publication of the American Diabetes Association
Vishal Ahuja, Chia-Hung Chou
The number of available therapies for treating type 2 diabetes has grown considerably in recent years. This growth has been fueled by availability of newer medications, whose benefits and risks have not been fully established. In this study, we review and synthesize the existing literature on the uptake, efficacy, safety, and cost-effectiveness of novel antidiabetic agents. Specifically, we focus on three drug classes that were introduced in the market recently: thiazolidinediones (TZDs), dipeptidyl peptidase-4 (DPP-4) inhibitors, and glucagon-like peptide-1 (GLP-1) receptor agonists...
June 2016: Current Diabetes Reports
Hui Wang, Xiufei Liu, Min Long, Yi Huang, Linlin Zhang, Rui Zhang, Yi Zheng, Xiaoyu Liao, Yuren Wang, Qian Liao, Wenjie Li, Zili Tang, Qiang Tong, Xiaocui Wang, Fang Fang, Montserrat Rojo de la Vega, Qin Ouyang, Donna D Zhang, Shicang Yu, Hongting Zheng
Cancer is a common comorbidity of diabetic patients; however, little is known about the effects that antidiabetic drugs have on tumors. We discovered that common classes of drugs used in type 2 diabetes mellitus, the hypoglycemic dipeptidyl peptidase-4 inhibitors (DPP-4i) saxagliptin and sitagliptin, as well as the antineuropathic α-lipoic acid (ALA), do not increase tumor incidence but increase the risk of metastasis of existing tumors. Specifically, these drugs induce prolonged activation of the nuclear factor E2-related factor 2 (NRF2)-mediated antioxidant response through inhibition of KEAP1-C151-dependent ubiquitination and subsequent degradation of NRF2, resulting in up-regulated expression of metastasis-associated proteins, increased cancer cell migration, and promotion of metastasis in xenograft mouse models...
April 13, 2016: Science Translational Medicine
E Raschi, E Poluzzi, A Koci, I C Antonazzo, G Marchesini, F De Ponti
BACKGROUND AND AIMS: We tested the possible association between dipeptidyl peptidase-4 inhibitors (DPP-4-I) use and heart failure (HF) occurrence by assessing the publicly available US-FDA Adverse Event Reporting System (FAERS). METHODS: FAERS data reporting HF and DPP-4-Is use in the period from the fourth quarter of 2006 through 2013 were extracted, using the Standardized MedDRA Query "Cardiac failure". Disproportionality (case/non-case method) was implemented by calculating Reporting Odds Ratios (RORs) with 95% Confidence Interval (CI): (1) exploratory analysis on the entire FAERS (using rosiglitazone as positive control); (2) consolidated analyses by therapeutic area (within antidiabetics), correcting for event- and drug-related competition bias and adjusting for co-reported drugs as confounders...
May 2016: Nutrition, Metabolism, and Cardiovascular Diseases: NMCD
Huang-Tz Ou, Kai-Cheng Chang, Ya-Ming Liu, Jin-Shang Wu
BACKGROUND: Studies from other countries have indicated that the utilization patterns of antidiabetic drugs changed significantly after the introduction of newer classes of antidiabetic drugs (e.g., dipeptidyl peptidase-4 inhibitors; DDP4i). Evidence on recent trends of antidiabetic drug utilization in Taiwan is lacking, especially for the time after newer classes of drugs (e.g., DPP4i) were introduced. This study therefore assessed (1) recent trends in the utilization and spending on antidiabetic drugs, (2) change in utilization patterns after newer classes of antidiabetic drugs were introduced, and (3) factors associated with the choice of newer versus older classes of antidiabetic drugs...
April 6, 2016: Journal of Diabetes
Awadhesh Kumar Singh, Ritu Singh
As type 2 diabetes mellitus (T2DM) is a chronic and progressive disease with multiple pathophysiologic defects, no single anti-diabetic agent can tackle all these multi-factorial pathways. Consequently, multiple agents working through the different mechanisms will be required for the optimal glycemic control. Moreover, the combination therapies of different anti-diabetic agents may complement their actions and possibly act synergistic. Furthermore, these combinations could possess the additional properties to counter their undesired physiological compensatory response...
March 2016: Indian Journal of Endocrinology and Metabolism
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