Key result
Linagliptin added to RAAS blockers is linked to ~0.5% lower HbA1c without impairing renal function.
Why the study?
The effects and safety of linagliptin as an add-on therapy in patients with advanced-stage diabetic nephropathy taking RAAS blockers were not well established.
Does linagliptin improve glucose and lipid metabolism without impairing renal function in patients with advanced-stage diabetic nephropathy taking RAAS blockers?
Does linagliptin improve glucose and lipid metabolism without impairing renal function in patients with advanced-stage diabetic nephropathy taking RAAS blockers?
Absolute Event Rate: 6.85% vs 7.32%
p-value: p=<0.05
Linagliptin safely improves glycemic and lipid profiles in patients with advanced diabetic nephropathy on RAAS blockers without worsening renal function.
May support linagliptin addition in advanced diabetic nephropathy on RAAS blockers; hypothesis-generating and requires RCT confirmation.
BACKGROUND: We investigated the effects and safety of linagliptin as an add-on therapy in patients with advanced-stage diabetic nephropathy (DMN) taking renin-angiotensin-aldosterone system (RAAS) blockers. METHOD: Twenty advanced-stage DMN patients (estimated glomerular filtration rate (eGFR): 24.5 ± 13.4 mL/min/1.73 m(2)) taking RAAS blockers were administered 5 mg/day linagliptin for 52 weeks. Changes in glucose and lipid metabolism and renal function were evaluated. RESULTS: Linagliptin decreased glycosylated hemoglobin levels (from 7.32 ± 0.77% to 6.85 ± 0.87%, P < 0.05) without changing fasting blood glucose levels, and significantly decreased total cholesterol levels (from 189.6 ± 49.0 to 170.2 ± 39.2 mg/dL, P < 0.05) and low-density lipoprotein cholesterol levels (from 107.1 ± 32.4 to 90.2 ± 31.0 mg/dL, P < 0.05) without changing high-density lipoprotein cholesterol and triglyceride levels. Urine protein/creatinine ratio and annual change in eGFR remained unchanged. No adverse effects were observed. CONCLUSION: Linagliptin as an add-on therapy had beneficial effects on glucose and lipid metabolism without impairment of renal function, and did not have any adverse effects in this population of patients with advanced-stage DMN taking RAAS blockers.
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Ueda et al. (2016) studied Advanced-stage diabetic nephropathy (n=20). Linagliptin vs. Baseline was evaluated on Glycosylated hemoglobin levels (p=<0.05). Linagliptin 5 mg/day added to RAAS blockers for 52 weeks significantly decreased HbA1c (from 7.32% to 6.85%, P<0.05) and LDL cholesterol without impairing renal function in diabetic nephropathy.
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