Anagliptin Safe and Effective Option for Type 2 Diabetes Management with Potential LDL-C Benefits: Study

The study investigating the safety and efficacy of anagliptin provided reassuring evidence of its good glycemic control, safety, and tolerability over an extended period of clinical use in T2D patients.

"Additional evidence is necessary to confirm the LDL-C-lowering benefits of anagliptin and to determine the impact of small reductions in LDL-C on the prevention of cardiovascular events among the drug users," the researchers wrote in Medicine Journal.

Anagliptin works by enhancing the body's incretin hormones, which play a crucial role in regulating blood sugar levels. By inhibiting the DPP-4 enzyme, anagliptin increases insulin secretion and decreases glucagon levels in response to meals.

No comprehensive meta-analysis has examined and consolidated the effectiveness and safety of anagliptin in type 2 diabetes treatment. Deep Dutta, Department of Endocrinology, CEDAR Superspeciality Healthcare, Dwarka, New Delhi, India, and colleagues undertook this meta-analysis to fill this knowledge gap.

For this purpose, the researchers identified randomized controlled trials involving patients with type 2 diabetes receiving anagliptin through electronic databases. The control group included either an active comparator (Active Control Group [ACG]) or a placebo (Passive Control Group [PCG]). The primary outcome measured was glycated hemoglobin (HbA1c), while secondary outcomes included fasting plasma glucose (FPG), lipid profiles, and adverse events.

The researchers reported the following findings:

· From the 226 articles first examined, ten randomized controlled trials with 970 participants were analyzed. Reductions in HbA1c (mean difference [MD]: −0.03%) and FPG (MD: 0.03 mmol/L) were similar in the anagliptin group and ACG. Anagliptin reduced FPG better than placebo (MD: −1.25 mmol/L).

· Sufficient data were unavailable to analyze the HbA1c lowering with anagliptin versus placebo.

· Among the lipid parameters, changes in total cholesterol, high-density lipoprotein cholesterol, apolipoprotein B48, and apolipoprotein B100 were identical between the anagliptin and control groups (PCG and ACG).

· Anagliptin was better than ACG at lowering low-density lipoprotein cholesterol but not as good at lowering triglyceride. Adverse events were infrequent and similar in the anagliptin and control groups (PCG and ACG).

In conclusion, the current meta-analysis obtained the findings from RCTs investigating anagliptin in T2D patients published to date. It stresses the drug’s efficacy in glycemic control and its safety profile compared to several controls, such as placebo and other antihyperglycemic agents (AHAs). Anagliptin shows comparable efficacy in decreasing HbA1c levels compared to other AHAs while exhibiting an identical incidence of adverse events.

Reference:

Kamrul-Hasan, A.B.M. MBBS, MDa,*; Dutta, Deep MBBS, MD, DM, DNB, FRCPb; Nagendra, Lakshmi MBBS, MRCP, MD, DM, DrNBc; Sharma, Meha MBBS, MD, DMd; Patra, Shinjan MBBS, MD, DMe; Bhattacharya, Saptarshi MBBS, MD, DMf. Role of anagliptin, a dipeptidyl peptidase-4 inhibitor, in managing type 2 diabetes: A systematic review and meta-analysis. Medicine 103(28):p e38870, July 12, 2024. | DOI: 10.1097/MD.0000000000038870