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  1 / 1053 MEDLINE  
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PMID:28953663
Autor:Li M; Yang Y; Jiang D; Ying M; Wang Y; Zhao R
Endereço:aDepartment of Pharmacy, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou bDepartment of Biopharmaceutical, Yulin Normal University, Yulin cDepartment of Pharmacy, Zhu Jiang Hospital, Southern Medical University, Guangzhou, China.
Título:Efficacy and safety of liraglutide versus sitagliptin both in combination with metformin in patients with type 2 diabetes: A systematic review and meta-analysis.
Fonte:Medicine (Baltimore); 96(39):e8161, 2017 Sep.
ISSN:1536-5964
País de publicação:United States
Idioma:eng
Resumo:BACKGROUND: The aim of this systematic review was to evaluate the efficacy and safety of liraglutide versus sitagliptin both in combination with metformin in patients with type 2 diabetes and provide reference basis for rational use of clinical drugs. METHODS: Several databases were searched, including Web of science, PubMed, Cochrane library, CNKI, and Wanfang database. Only randomized controlled trials (RCTs) of liraglutide versus sitagliptin both in combination with metformin up to 31 August 2016 were included. Data were extracted independently by 2 reviewers, and a fixed or random effects model were used to analyze outcomes that were expressed as odds ratio (OR) or mean difference (MD) and 95% confidence intervals (95% CIs) for different situations. RESULTS: Five RCTs involving 1440 participants were included. Compared with sitagliptin combination with metformin group, participants' treatment with 1.2 mg and 1.8 mg liraglutide with metformin could significantly lower the level of glycosylated hemoglobin (HbA1c) (P < .00001, MD = -0.35, 95% CI -0.51 to -0.20). Moreover, patients with 1.8 mg liraglutide group had significant body weight loss (P < .00001, MD = -1.12, 95% CI -1.54 to -0.70). However, there were no obvious differences in cutting down the systolic blood pressure and diastolic blood pressure between liraglutide-metformin and sitagliptin-metformin groups. The incidence of gastrointestinal problems was significantly higher than sitagliptin with metformin groups. CONCLUSION: The results of this meta-analysis indicated that Liraglutide added on to metformin therapy could significantly lower the level of HbA1c and increase body weight loss. Meanwhile, the adverse reactions such as gastrointestinal problems were common in the liraglutide treatment group. Thus, this will provide an important reference for the treatment of patients with type 2 diabetes.
Tipo de publicação: JOURNAL ARTICLE; META-ANALYSIS; REVIEW
Nome de substância:0 (Glycated Hemoglobin A); 0 (Hypoglycemic Agents); 839I73S42A (Liraglutide); 9100L32L2N (Metformin); TS63EW8X6F (Sitagliptin Phosphate)


  2 / 1053 MEDLINE  
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PMID:28847886
Autor:Navar AM; Gallup DS; Lokhnygina Y; Green JB; McGuire DK; Armstrong PW; Buse JB; Engel SS; Lachin JM; Standl E; Van de Werf F; Holman RR; Peterson ED; TECOS Study Group
Endereço:From the Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC (A.M.N., D.S.G., Y.L., J.B.G., E.D.P.); Division of Cardiology, University of Texas Southwestern Medical Center, Dallas (D.K.M.); Canadian VIGOUR Centre, University of Alberta, Edmonton, Canada (P.W.A.); Divisi
Título:Hypertension Control in Adults With Diabetes Mellitus and Recurrent Cardiovascular Events: Global Results From the Trial Evaluating Cardiovascular Outcomes With Sitagliptin.
Fonte:Hypertension; 70(5):907-914, 2017 Nov.
ISSN:1524-4563
País de publicação:United States
Idioma:eng
Resumo:Systolic blood pressure (SBP) treatment targets for adults with diabetes mellitus remain unclear. SBP levels among 12 275 adults with diabetes mellitus, prior cardiovascular disease, and treated hypertension were evaluated in the TECOS (Trial Evaluating Cardiovascular Outcomes With Sitagliptin) randomized trial of sitagliptin versus placebo. The association between baseline SBP and recurrent cardiovascular disease was evaluated using multivariable Cox proportional hazards modeling with restricted cubic splines, adjusting for clinical characteristics. Kaplan-Meier curves by baseline SBP were created to assess time to cardiovascular disease and 2 potential hypotension-related adverse events: worsening kidney function and fractures. The association between time-updated SBP and outcomes was examined using multivariable Cox proportional hazards models. Overall, 42.2% of adults with diabetes mellitus, cardiovascular disease, and hypertension had an SBP ≥140 mm Hg. The association between SBP and cardiovascular disease risk was U shaped, with a nadir ≈130 mm Hg. When the analysis was restricted to those with baseline SBP of 110 to 150 mm Hg, the adjusted association between SBP and cardiovascular disease risk was flat (hazard ratio per 10-mm Hg increase, 0.96; 95% confidence interval, 0.91-1.02). There was no association between SBP and risk of fracture. Above 150 mm Hg, higher SBP was associated with increasing risk of worsening kidney function (hazard ratio per 10-mm Hg increase, 1.10; 95% confidence interval, 1.02-1.18). Many patients with diabetes mellitus have uncontrolled hypertension. The U-shaped association between SBP and cardiovascular disease events was largely driven by those with very high or low SBP, with no difference in cardiovascular disease risk between 110 and 150 mm Hg. Lower SBP was not associated with higher risks of fractures or worsening kidney function.
Tipo de publicação: JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
Nome de substância:0 (Antihypertensive Agents); 0 (Hypoglycemic Agents); TS63EW8X6F (Sitagliptin Phosphate)


  3 / 1053 MEDLINE  
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PMID:28626088
Autor:Pagidipati NJ; Navar AM; Pieper KS; Green JB; Bethel MA; Armstrong PW; Josse RG; McGuire DK; Lokhnygina Y; Cornel JH; Halvorsen S; Strandberg TE; Delibasi T; Holman RR; Peterson ED; TECOS Study Group
Endereço:From Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC (N.J.P., A.M.N., K.S.P., J.B.G., Y.L., E.D.P.); Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, United Kingdom (M.A.B., R.R.H.); Canadian VIGOUR Centre, Univers
Título:Secondary Prevention of Cardiovascular Disease in Patients With Type 2 Diabetes Mellitus: International Insights From the TECOS Trial (Trial Evaluating Cardiovascular Outcomes With Sitagliptin).
Fonte:Circulation; 136(13):1193-1203, 2017 Sep 26.
ISSN:1524-4539
País de publicação:United States
Idioma:eng
Resumo:BACKGROUND: Intensive risk factor modification significantly improves outcomes for patients with diabetes mellitus and cardiovascular disease. However, the degree to which secondary prevention treatment goals are achieved in international clinical practice is unknown. METHODS: Attainment of 5 secondary prevention parameters-aspirin use, lipid control (low-density lipoprotein cholesterol <70 mg/dL or statin therapy), blood pressure control (<140 mm Hg systolic, <90 mm Hg diastolic), angiotensin-converting enzyme inhibitor or angiotensin receptor blocker use, and nonsmoking status-was evaluated among 13 616 patients from 38 countries with diabetes mellitus and known cardiovascular disease at entry into TECOS (Trial Evaluating Cardiovascular Outcomes With Sitagliptin). Logistic regression was used to evaluate the association between individual and regional factors and secondary prevention achievement at baseline. Cox proportional hazards regression analysis was used to determine the association between baseline secondary prevention achievement and cardiovascular death, myocardial infarction, or stroke. RESULTS: Overall, 29.9% of patients with diabetes mellitus and cardiovascular disease achieved all 5 secondary prevention parameters at baseline, although 71.8% achieved at least 4 parameters. North America had the highest proportion (41.2%), whereas Western Europe, Eastern Europe, and Latin America had proportions of ≈25%. Individually, blood pressure control (57.9%) had the lowest overall attainment, whereas nonsmoking status had the highest (89%). Over a median 3.0 years of follow-up, a higher baseline secondary prevention score was associated with improved outcomes in a step-wise graded relationship (adjusted hazard ratio, 0.60; 95% confidence interval, 0.47-0.77 for those patients achieving all 5 measures versus those achieving ≤2). CONCLUSIONS: In an international trial population, significant opportunities exist to improve the quality of cardiovascular secondary prevention care among patients with diabetes mellitus and cardiovascular disease, which in turn could lead to reduced risk of downstream cardiovascular events. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00790205.
Tipo de publicação: JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
Nome de substância:0 (Angiotensin Receptor Antagonists); 0 (Angiotensin-Converting Enzyme Inhibitors); 0 (Cholesterol, LDL); 0 (Hypoglycemic Agents); R16CO5Y76E (Aspirin); TS63EW8X6F (Sitagliptin Phosphate)


  4 / 1053 MEDLINE  
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PMID:28622738
Autor:Kaneko M; Narukawa M
Endereço:1 Department of Clinical Medicine (Pharmaceutical Medicine), Graduate School of Pharmaceutical Sciences, Kitasato University, Tokyo, Japan.
Título:Assessment of the Risk of Hospitalization for Heart Failure With Dipeptidyl Peptidase-4 Inhibitors, Saxagliptin, Alogliptin, and Sitagliptin in Patients With Type 2 Diabetes, Using an Alternative Measure to the Hazard Ratio.
Fonte:Ann Pharmacother; 51(7):570-576, 2017 Jul.
ISSN:1542-6270
País de publicação:United States
Idioma:eng
Resumo:BACKGROUND: Saxagliptin statistically significantly increased the risk of hospitalization for heart failure compared with placebo in the clinical trial of SAVOR-TIMI 53. Neither the reason why only saxagliptin among several dipeptidyl peptidase-4 (DPP-4) inhibitors increased the risk, nor the clinical implication of the result has been explained. OBJECTIVE: To evaluate the risk of hospitalization for heart failure associated with DPP-4 inhibitors by using an alternative measure to the hazard ratio. METHODS: We used the difference in restricted mean survival time (RMST) between DPP-4 inhibitors and placebo to evaluate the risk of cardiovascular events, including hospitalization for heart failure associated with DPP-4 inhibitors. Three randomized clinical trials with cardiovascular events as a primary end point-EXAMINE (alogliptin), SAVOR-TIMI 53 (saxagliptin), and TECOS (sitagliptin)-were reevaluated by estimating the RMSTs for the DPP-4 inhibitors and placebo based on the reconstructed individual patient data for each time-to-event outcome from publicly available information. RESULTS: The differences of RMSTs (DPP-4 inhibitors minus placebo) for hospitalization for heart failure were -4 days [-6, -2] in the SAVOR-TIMI 53 (720 days follow-up), -3 days [-9, 3] in the EXAMINE (900 days follow-up), and 1 day [-5, 7] in the TECOS (1440 days follow-up). There were no substantial differences in the risk of other cardiovascular outcomes between DPP-4 inhibitors and placebo. CONCLUSIONS: There are no substantial clinically relevant differences in the risk of cardiovascular events, including hospitalization for heart failure, between 3 of the DPP-4 inhibitors and placebo.
Tipo de publicação: JOURNAL ARTICLE
Nome de substância:0 (Dipeptides); 0 (Dipeptidyl-Peptidase IV Inhibitors); 0 (Piperidines); 56HH86ZVCT (Uracil); 9GB927LAJW (saxagliptin); JHC049LO86 (alogliptin); PJY633525U (Adamantane); TS63EW8X6F (Sitagliptin Phosphate)


  5 / 1053 MEDLINE  
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PMID:28575350
Autor:Lee JJ; Wang TY; Liu CL; Chien MN; Chen MJ; Hsu YC; Leung CH; Cheng SP
Endereço:Department of Surgery, MacKay Memorial Hospital and Mackay Medical College, Taipei 10449, Taiwan.
Título:Dipeptidyl Peptidase IV as a Prognostic Marker and Therapeutic Target in Papillary Thyroid Carcinoma.
Fonte:J Clin Endocrinol Metab; 102(8):2930-2940, 2017 Aug 01.
ISSN:1945-7197
País de publicação:United States
Idioma:eng
Resumo:Context: Dipeptidyl peptidase IV (DPP4) is overexpressed in thyroid cancer and certain malignancies. Furthermore, DPP4 has been identified as a discriminatory marker for thyroid cancer. However, it remains unclear whether DPP4 expression plays a prognostic role. Objective: The aim of this study was to investigate the expression and function of DPP4 in thyroid cancer and the mechanisms involved. Design: We determined the expression of DPP4 by immunohistochemistry in tissue microarrays of thyroid tumors. In vitro functional studies were performed after genetic and pharmacological inhibition of DPP4. Gene expression and pathway analyses were used to identify downstream targets. The therapeutic potential of DPP4 inhibition was evaluated in a mouse xenograft model. Results: High DPP4 expression was associated with extrathyroidal extension (P < 0.001), BRAF mutation (P < 0.001), and advanced tumor stage (P = 0.007) in papillary thyroid cancer. Patients in the high-DPP4 expression group were less likely to be classified as having no evidence of disease at final follow-up (P = 0.042). DPP4 silencing or treatment with DPP4 inhibitors significantly suppressed colony formation, cell migration, and invasion. Analysis of differentially expressed genes after DPP4 knockdown suggested that the transforming growth factor-ß signaling pathway is involved. In vivo experiments revealed that sitagliptin treatment reduced tumor growth and xenograft transforming growth factor-ß receptor I expression. Conclusions: Increased DPP4 expression is associated with cellular invasion and more aggressive disease in papillary thyroid cancer. Targeting DPP4 may be a therapeutic strategy for DPP4-expressing thyroid cancer.
Tipo de publicação: JOURNAL ARTICLE
Nome de substância:0 (Dipeptidyl-Peptidase IV Inhibitors); 0 (RNA, Small Interfering); 0 (Transforming Growth Factor beta); EC 2.7.11.1 (BRAF protein, human); EC 2.7.11.1 (Proto-Oncogene Proteins B-raf); EC 3.4.14.5 (DPP4 protein, human); EC 3.4.14.5 (Dipeptidyl Peptidase 4); TS63EW8X6F (Sitagliptin Phosphate)


  6 / 1053 MEDLINE  
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PMID:28511152
Autor:Чопей ІВ; Івачевська ВВ; Чубірко КІ; Гряділь ТІ; Гечко ММ
Endereço:ДВНЗ ≪УЖГОРОДСЬКИЙ НАЦІОНАЛЬНИЙ УНІВЕРСИТЕТ≫, ФАКУЛЬТЕТ ПІСЛЯДИПЛОМНОЇ ОСВІТИ ТА ДОУНІВЕРСИТЕТСЬКОЇ ПІДГОТОВКИ, КАФЕДРА ТЕРАПІЇ ТА СІМЕЙНОЇ МЕДИЦИНИ, УЖГОРОД,
Título:[Pathogenetic substantiation of complex treatment of nonalcoholic steatohepatitis and steatosis in patients with pre-diabetes and type 2 diabetes].
Fonte:Wiad Lek; 70(2):169-173, 2017.
ISSN:0043-5147
País de publicação:Poland
Idioma:ukr
Resumo:INTRODUCTION: Thesis is devoted to the optimization of complex treatment of nonalcoholic steatohepatitis and steatosis in patients with pre-diabetes and type 2 diabetes by acting on carbohydrate and lipid metabolism as well as providing hepatoprotection. AIM: Optimization of diagnostics and treatment in patients treatment of nonalcoholic steatohepatitis and steatosis in patients with pre-diabetes and type 2 diabetes. MATERIAL AND METHODS: Examination and treatment of 117 patients with NAFLD and pre-diabetes and type 2 diabetes was performed. RESULTS: It has been proved that the use of a therapeutic scheme that includes a balanced diet, taking into account the daily requirement in proteins, fats and carbohydrates, daily 30-minute walks at a brisk pace, rosuvastatin 10 mg/d, omega-3 PUFA 1000 mg/d and ursodeoxycholic acid 10 mg/kg/d in patients with NAFLD and pre-diabetes facilitates regression of signs of steatosis. In patients with NAFLD and type 2 diabetes the above mentioned therapeutic scheme including sitagliptin 100 mg/d promotes regression of steatohepatitis in steatosis. CONCLUSIONS: The prevalence of nonalcoholic steatohepatitis and liver steatosis in patients with pre-diabetes has been studied. It has been proved that patients with NAFLD and pre-diabetes belong to the group with high cardiovascular risk. The features of metabolic disorders in patients with nonalcoholic fatty liver disease and pre-diabetes or type 2 diabetes were researched. Differentiated treatment schemes of nonalcoholic steatosis and steatohepatitis in patients with pre-diabetes and type 2 diabetes have been approved for use.
Tipo de publicação: JOURNAL ARTICLE
Nome de substância:0 (Anticholesteremic Agents); 0 (Fatty Acids, Omega-3); 0 (Hypoglycemic Agents); 83MVU38M7Q (Rosuvastatin Calcium); TS63EW8X6F (Sitagliptin Phosphate)


  7 / 1053 MEDLINE  
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PMID:28372289
Autor:Sun Q; Zhang Y; Huang J; Yu F; Xu J; Peng B; Liu W; Han S; Yin J; He X
Endereço:Department of Pathophysiology, School of Basic Medical Sciences, Wuhan University, Wuhan, China.
Título:DPP4 regulates the inflammatory response in a rat model of febrile seizures.
Fonte:Biomed Mater Eng; 28(s1):S139-S152, 2017.
ISSN:1878-3619
País de publicação:Netherlands
Idioma:eng
Resumo:Febrile seizures (FS) are the most common seizure disorders in children aged 6 months to 5 years. Children suffering from complex FS have a high risk of developing subsequent temporal lobe epilepsy (TLE). Neuroinflammation is involved in the pathogenesis of FS although the mechanism remains unknown. Our previous study using the Whole Rat Genome Oligo Microarray determined that Dipeptidyl peptidase IV (DPP4) is potentially a related gene in FS rats. In this study, we demonstrated that DPP4 expression was significantly increased at both the protein and mRNA levels after hyperthermia induction. Sitagliptin, a specific enzyme inhibitor of DPP4, remarkably attenuated the severity of seizures in FS rats, and hyperthermia-induced astrocytosis was suppressed after DPP4 inhibition. Furthermore, sitagliptin significantly decreased the levels of the inflammatory cytokines IL-1ß, TNF-α, and IL-6 but not IL-10. In addition, sitagliptin prevented NF-κB activation by decreasing phosphorylation of the p65 subunit. Taken together, our findings demonstrate that DPP4 functions as a critical regulator of neuroinflammation in hyperthermia-induced seizures and the DPP4 inhibitor may be a viable option for FS therapeutics.
Tipo de publicação: JOURNAL ARTICLE
Nome de substância:0 (Dipeptidyl-Peptidase IV Inhibitors); 0 (NF-kappa B); EC 3.4.14.5 (Dipeptidyl Peptidase 4); TS63EW8X6F (Sitagliptin Phosphate)


  8 / 1053 MEDLINE  
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PMID:28368384
Autor:Tuesta LM; Chen Z; Duncan A; Fowler CD; Ishikawa M; Lee BR; Liu XA; Lu Q; Cameron M; Hayes MR; Kamenecka TM; Pletcher M; Kenny PJ
Endereço:Department of Molecular Therapeutics, The Scripps Research Institute Jupiter, Florida, USA.
Título:GLP-1 acts on habenular avoidance circuits to control nicotine intake.
Fonte:Nat Neurosci; 20(5):708-716, 2017 May.
ISSN:1546-1726
País de publicação:United States
Idioma:eng
Resumo:Tobacco smokers titrate their nicotine intake to avoid its noxious effects, sensitivity to which may influence vulnerability to tobacco dependence, yet mechanisms of nicotine avoidance are poorly understood. Here we show that nicotine activates glucagon-like peptide-1 (GLP-1) neurons in the nucleus tractus solitarius (NTS). The antidiabetic drugs sitagliptin and exenatide, which inhibit GLP-1 breakdown and stimulate GLP-1 receptors, respectively, decreased nicotine intake in mice. Chemogenetic activation of GLP-1 neurons in NTS similarly decreased nicotine intake. Conversely, Glp1r knockout mice consumed greater quantities of nicotine than wild-type mice. Using optogenetic stimulation, we show that GLP-1 excites medial habenular (MHb) projections to the interpeduncular nucleus (IPN). Activation of GLP-1 receptors in the MHb-IPN circuit abolished nicotine reward and decreased nicotine intake, whereas their knockdown or pharmacological blockade increased intake. GLP-1 neurons may therefore serve as 'satiety sensors' for nicotine that stimulate habenular systems to promote nicotine avoidance before its aversive effects are encountered.
Tipo de publicação: JOURNAL ARTICLE
Nome de substância:0 (Glucagon-Like Peptide-1 Receptor); 0 (Peptides); 0 (Venoms); 6M3C89ZY6R (Nicotine); 89750-14-1 (Glucagon-Like Peptide 1); 9P1872D4OL (exenatide); TS63EW8X6F (Sitagliptin Phosphate)


  9 / 1053 MEDLINE  
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PMID:28334048
Autor:Abo-Haded HM; Elkablawy MA; Al-Johani Z; Al-Ahmadi O; El-Agamy DS
Endereço:Cardio-genetic team, College of Medicine, Taibah University, Almadinah Almonawarah, Saudi Arabia.
Título:Hepatoprotective effect of sitagliptin against methotrexate induced liver toxicity.
Fonte:PLoS One; 12(3):e0174295, 2017.
ISSN:1932-6203
País de publicação:United States
Idioma:eng
Resumo:Sitagliptin is selective dipeptidyl peptidase-4 inhibitor (DPP4-I), used clinically as a new oral anti-diabetic agent. This study explored the underlying mechanisms of the hepatoprotective role of sitagliptin pretreatment against methotrexate (MTX) induced hepatotoxicity in mice. Forty mice were divided into four groups (10 mice each); control, MTX, and two sitagliptin groups (pretreated with sitagliptin 10 and 20 mg/kg/day, respectively) for five consecutive days prior to MTX injection. Results showed that MTX induced marked hepatic injury in the form of cloudy swelling, hydropic degeneration, apoptosis and focal necrosis in all hepatic zones. Biochemical analysis revealed significant increase in the serum transaminases, alkaline phosphatase and lactate dehydrogenase in MTX group. Oxidative stress and depressed antioxidant system of the hepatic tissues were evident in MTX group. MTX down-regulated nuclear factor erythroid 2-related factor 2 (Nrf2) expression and reduced its binding capacity. Additionally, MTX increased the activation and the expression of nuclear factor kappa-B (NF-κB) and downstream inflammatory mediators. MTX induced the activation of inducible nitric oxide synthase (iNOS) and increased nitrite/nitrate level. Finally, hepatic cellular apoptosis was clearly obvious in MTX-intoxicated animals using TUNEL staining. Also, there was increase in the immunoexpression of pro-apoptotic protein Bax, increase in Bax and caspase-3 levels and decrease in the level of anti-apoptotic Bcl2 in liver. On the other hand, sitagliptin pretreatment significantly ameliorated all of the above mentioned biochemical, histopathological, immunohistochemical changes induced by MTX. These results provide new evidences that the hepatoprotective effect of sitagliptin is possibly mediated through modulation of Nrf2 and NF-κB signaling pathways with subsequent suppression of inflammatory and apoptotic processes.
Tipo de publicação: JOURNAL ARTICLE
Nome de substância:0 (NF-kappa B); TS63EW8X6F (Sitagliptin Phosphate); YL5FZ2Y5U1 (Methotrexate)


  10 / 1053 MEDLINE  
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PMID:28332871
Autor:Lingvay I
Título:SODIUM GLUCOSE COTRANSPORTER 2 AND DIPEPTIDYL PEPTIDASE-4 INHIBITION: PROMISE OF A DYNAMIC DUO.
Fonte:Endocr Pract; 23(7):831-840, 2017 Jul.
ISSN:1530-891X
País de publicação:United States
Idioma:eng
Resumo:OBJECTIVE: This article reviews evidence supporting sodium glucose cotransporter 2 (SGLT2) inhibitor and dipeptidyl peptidase-4 (DPP-4) inhibitor combination therapy for management of type 2 diabetes mellitus (T2DM). METHODS: We conducted a nonsystematic review of the literature focusing on single-pill or fixed-dose combinations of SGLT2 inhibitors and DPP-4 inhibitors available in the United States. RESULTS: SGLT2 inhibitors and DPP-4 inhibitors have complementary mechanisms of action that address several of the underlying pathophysiologic abnormalities present in T2DM without overlapping toxicities. The combination of these 2 agents has several advantages including a low risk of hypoglycemia, the potential for weight loss, the ability to coformulate into a pill with once-daily administration, and the possibility to use with other classes of glucose-lowering agents. Cardiovascular outcomes trials reported to date support the safety of the DPP-4 class and suggest possible cardioprotective effects for SGLT2 inhibitors - at least based on the first reported study that used empagliflozin. Recent clinical evidence shows that SGLT2 inhibitor/DPP-4 inhibitor therapy is an effective combination for T2DM treatment, providing glycated hemoglobin (HbA1c) reductions of 1.1 to 1.5%, and weight reductions of approximately 2 kg when added to metformin, which is its primary place in therapy. CONCLUSION: The combination of an SGLT2 inhibitor/DPP-4 inhibitor is a safe and effective treatment choice for patients with T2DM who are unable to obtain adequate glycemic control with metformin therapy, cannot use metformin, or have a higher baseline HbA1c. ABBREVIATIONS: BP = blood pressure; CI = confidence interval; CVOT = cardiovascular outcomes; DKA = diabetic ketoacidosis; DPP-4 = dipeptidyl peptidase-4; EXAMINE = EXamination of cArdiovascular outcoMes with alogliptiN versus standard of carE in patients with type 2 diabetes mellitus and acute coronary syndrome; FDA = Food and Drug Administration; HbA1c = glycated hemoglobin; HR = hazard ratio; MACE = major adverse cardiovascular events; SAVOR-TIMI 53 = Saxagliptin Assessment of Vascular Outcomes Recorded in Patients with Type 2 Diabetes Mellitus; SBP = systolic blood pressure; SGLT2 = sodium glucose cotransporter 2; TECOS = Trial to Evaluate Cardiovascular Outcomes after Treatment with Sitagliptin; T2DM = type 2 diabetes mellitus; XR = extended release.
Tipo de publicação: JOURNAL ARTICLE; REVIEW
Nome de substância:0 (2-(3-(4-ethoxybenzyl)-4-chlorophenyl)-6-hydroxymethyltetrahydro-2H-pyran-3,4,5-triol); 0 (Benzhydryl Compounds); 0 (Blood Glucose); 0 (Dipeptides); 0 (Dipeptidyl-Peptidase IV Inhibitors); 0 (Glucosides); 0 (Hypoglycemic Agents); 0 (Piperidines); 0 (Sodium-Glucose Transporter 2); 0SAC974Z85 (Canagliflozin); 3X29ZEJ4R2 (Linagliptin); 56HH86ZVCT (Uracil); 9100L32L2N (Metformin); 9GB927LAJW (saxagliptin); HDC1R2M35U (empagliflozin); JHC049LO86 (alogliptin); PJY633525U (Adamantane); TS63EW8X6F (Sitagliptin Phosphate)



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