沙沙利汀
阿格列汀
医学
磷酸西他列汀
维尔达格利普汀
利格列汀
多囊卵巢
子宫的
吡格列酮
二甲双胍
糖尿病
二肽基肽酶-4
内科学
2型糖尿病
药理学
肠促胰岛素
2型糖尿病
重症监护医学
内分泌学
胰岛素抵抗
催产素
作者
Nikhila A. Subrahmanyan,Rithika Mary Koshy,Koshy Jacob,Joseph M Pappachan
出处
期刊:Current Drug Safety
[Bentham Science]
日期:2021-06-08
卷期号:16 (2): 154-164
被引量:24
标识
DOI:10.2174/1574886315999200819150544
摘要
Abstract:: Dipeptidyl peptidase-4 (DPP-4) inhibitors or gliptins belong to the class of incretin mimetics. These drugs have been available on the market for the management of type 2 diabetes mellitus (T2DM) for over a decade. Sitagliptin, linagliptin, vildagliptin, saxagliptin and alogliptin are widely available globally, whilst anagliptin, gemigliptin and teneliptin are used mainly in the Asian countries. The glycemic control conferred by DPP-4 inhibitors varies among individual molecules with an average reduction of glycated hemoglobin (HbA1c) ranging between –0.5 to –1.0% with monotherapy. Additive effects on HbA1c reduction may result from combination therapy with other antidiabetics. Weak evidence from various studies suggests that DPP-4 inhibitors may be useful in treating nonalcoholic fatty liver disease (NAFLD) and polycystic ovary syndrome (PCOS). DPP-4 inhibitors safety is not established in pregnancy, and there is only meagre evidence of its use in T2DM among children. In line with the United States Food and Drug Administration (US FDA) recommendations, sitagliptin, linagliptin, saxagliptin and alogliptin have undergone rigorous cardiovascular outcome trials (CVOTs) in recent years, and the safety data for vildagliptin is available through retrospective analysis of various studies in meta-analysis. Small clinical trial, and meta-analysis based data are available for the CV safety of other DPP-4 inhibitors. In general, the CVOTs and other safety data do not reveal serious warning signals except for saxagliptin (higher risk of hospitalization from heart failure [hHF]), although there is no robust data on the risk of hHF among patients with moderate to severe HF at baseline treated with other DPP-4 inhibitors. This review critically appraises the efficacy and cardiovascular safety of DPP-4 inhibitors to empower clinicians to use this class of antidiabetic medications judiciously.
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