Key result
Sitagliptin linked to decreased eGFR at 12 months, driven by patients with high baseline eGFR.
Why the study?
The effects of sitagliptin on renal function in diabetic patients including those with normal renal function were not well characterized.
Does sitagliptin 50 mg/day alter estimated glomerular filtration rate and urinary albumin-to-creatinine ratio in outpatients with type 2 diabetes mellitus?
Observational (n=651)
Open-label
Yes
Does sitagliptin 50 mg/day alter estimated glomerular filtration rate and urinary albumin-to-creatinine ratio in outpatients with type 2 diabetes mellitus?
Absolute Event Rate: 74.2% vs 78.1%
p-value: p=<0.05
In patients with type 2 diabetes, sitagliptin 50 mg/day is associated with a decline in eGFR in those with normal baseline renal function, but not in those with impaired baseline renal function, alongside a reduction in albuminuria.
Suggests eGFR monitoring for T2D patients with preserved function on sitagliptin; leaves open causality and need for RCTs.
Background: The aim of the study was to determine the effects of sitagliptin on renal function in a diabetic population including patients with normal renal function. Methods: We analyzed the association between 12-month, 50 mg/day sitagliptin and renal function in outpatients with type 2 diabetes mellitus and poor blood glucose control in a subset of patients in the larger Januvia Multicenter Prospective Trial in Type 2 Diabetes observational study. Stratified analyses of changes in estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (UACR) were performed. Factors associated with changes in eGFR at 3 months were examined by multivariate regression analysis. Results: Of the 779 patients enrolled, 585 were followed up for 12 months. eGFR decreased significantly from baseline at 3 and 12 months in patients with a baseline eGFR of ? 90 mL/min/1.73 m 2 and in those with a baseline eGFR of ? 60 to < 90 mL/min/1.73 m 2 . Conversely, eGFR tended to increase at 3 and 12 months in patients with a baseline eGFR of ? 45 to < 60 mL/min/1.73 m 2 and in those with a baseline eGFR of ? 30 to < 45 mL/min/1.73 m 2 . UACR decreased significantly (-21.6 (-46.8, 7.8)) at 3 months in patients with a baseline UACR of ? 30 mg/g Cre. Multivariate regression analysis of factors associated with changes in eGFR at 3 months revealed that higher baseline eGFR and greater decline in UACR were associated with more conspicuous decreases in eGFR. Conclusions: In this group of diabetic patients receiving sitagliptin, eGFR declined in patients with high baseline eGFR, but not in those with a low baseline eGFR. J Clin Med Res. 2018;10(1):32-40 doi: https://doi.org/10.14740/jocmr3225w
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Tomonaga et al. (2018) conducted an observational in Type 2 diabetes mellitus (n=651). Sitagliptin vs. Baseline was evaluated on Change in eGFR at 12 months (p=<0.05). Sitagliptin administration in patients with type 2 diabetes was associated with a significant decrease in eGFR at 12 months, primarily driven by declines in patients with high baseline eGFR.
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