Effects of Dipeptidyl Peptidase-4 Inhibitors on Hyperglycemia and Blood Cyclosporine Levels in Renal Transplant Patients with Diabetes: A Pilot Study.
10.3803/EnM.2016.31.1.161
- Author:
Jaehyun BAE
1
;
Min Jung LEE
;
Eun Yeong CHOE
;
Chang Hee JUNG
;
Hye Jin WANG
;
Myoung Soo KIM
;
Yu Seun KIM
;
Joong Yeol PARK
;
Eun Seok KANG
Author Information
1. Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. edgo@yuhs.ac
- Publication Type:Original Article
- Keywords:
Dipeptidyl-peptidase IV inhibitors;
Sitagliptin phosphate;
Vildagliptin;
Linagliptin;
Cyclosporine;
Kidney transplantation;
Diabetes mellitus
- MeSH:
Allografts;
Cyclosporine*;
Diabetes Mellitus;
Dipeptidyl-Peptidase IV Inhibitors;
Humans;
Hyperglycemia*;
Kidney;
Kidney Transplantation;
Pilot Projects*;
Transplantation
- From:Endocrinology and Metabolism
2016;31(1):161-167
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: The use of dipeptidyl peptidase-4 (DPP-4) inhibitors is increasing among renal transplant patients with diabetes. However, the glucose-lowering efficacies of various DPP-4 inhibitors and their effects on blood cyclosporine levels have not been fully investigated. We compared the glucose-lowering efficacies of DPP 4 inhibitors and evaluate their effects on the blood levels of cyclosporine in renal transplant recipients with diabetes. METHODS: Sixty-five renal allograft recipients who received treatment with DPP-4 inhibitors (vildagliptin, sitagliptin, or linagliptin) following kidney transplant were enrolled. The glucose-lowering efficacies of the DPP-4 inhibitors were compared according to the changes in the hemoglobin A1c (HbA1c) levels after 3 months of treatment. Changes in the trough levels of the cyclosporine were also assessed 2 months after treatment with each DPP-4 inhibitor. RESULTS: HbA1c significantly decreased in the linagliptin group in comparison with other DPP-4 inhibitors (vildagliptin –0.38%±1.03%, sitagliptin –0.53%±0.95%, and linagliptin –1.40±1.34; P=0.016). Cyclosporine trough levels were significantly increased in the sitagliptin group compared with vildagliptin group (30.62±81.70 ng/mL vs. –24.22±53.54 ng/mL, P=0.036). Cyclosporine trough levels were minimally changed in patients with linagliptin. CONCLUSION: Linagliptin demonstrates superior glucose-lowering efficacy and minimal effect on cyclosporine trough levels in comparison with other DPP-4 inhibitors in kidney transplant patients with diabetes.
