Physicians' Academy for Cardiovascular Education

DPP-4 inhibitor safe for diabetic patients with renal dysfunction

Safety of Sitagliptin in Patients with Type 2 Diabetes and Chronic Kidney Disease: Outcomes from TECOS

Engel SS, Suryawanshi S, Stevens SR, et al. - Diabetes Obes Metab. 2017; published online ahead of print

Background

Guidelines for the management of type 2 diabetes mellitus (T2DM) recommend the careful balancing of benefits of improved glycaemic control with the risks related to chronic kidney disease (CKD) adverse effects of glucose-lowering medications [1]. DPP-4 inhibitors improve glycaemia in patients with renal insufficiency, including patients on dialysis, and are well-tolerated for up to 1 year, but longer-term data regarding the safety and tolerability of DPP-4 inhibitors are limited [2-4].

The DPP-4 inhibitor sitagliptin, has been evaluated in the TECOS study, which included approximately 3,300 T2DM patients with CKD, and had a median follow-up period of 3 years [5]. In this analysis, the safety of sitagliptin was compared between participants with CKD and without CKD and between sitagliptin and placebo-treated CKD patients.

Main results

Conclusion

T2DM patients with CKD in the TECOS study had higher incidences of serious adverse events and diabetic complications compared with non-CKD participants. Compared to placebo, long-term treatment with sitagliptin was well tolerated in CKD participants, with no evidence of adverse impact on the safety endpoints in TECOS.

References

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Find this article online at Diabetes Obes Metab.