DPP-4 inhibitors and SGLT2 inhibitors effective in diabetics after kidney transplant
Greece:Evidence regarding the utilization of DPP-4 inhibitors and particularly SGLT2 inhibitors and GLP-1 receptor agonists is limited in renal transplant recipients (RTRs).
Incretin based therapies DPP-4 inhibitors and SGLT2 inhibitors are both safe and effective in recipients of kidney transplant, suggests a recent study published in the journal Diabetes Research and Clinical Practice.
There is a limited evidence on the use of DPP-4 inhibitors and particularly SGLT2 inhibitors and GLP-1 receptor agonists in renal transplant recipients (RTRs). Dora Oikonomaki, Evaggelismos General Hospital, Athens, Greece, and colleagues therefore, aimed to conduct a systematic review and meta-analysis regarding the utility of incretin-based therapies including dipeptidyl peptidase-4 (DPP-4) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists as well as sodium-glucose co-transporter-2 (SGLT2) inhibitors in people with posttransplantation diabetes mellitus (PTDM).
For the purpose, the researchers searched the online databases for publications on Kidney/Renal Transplantation and DPP-4 inhibitors, GLP-1-receptor agonists and SGLT-2 inhibitors. It included studies that in which these antidiabetics were used.
Overall, sixteen studies and 310 people were included in the analysis.
Key findings of the study include:
- Participants received DPP-4 inhibitors in 8 studies, SGLT-2 inhibitors in 6 studies and GLP-1 receptor agonists in 2 studies, with a mean follow-up of 22.03 ± 14.95 weeks.
- Hemoglobin A1c (HbA1c) reduction was demonstrated in 10 studies (mean +/- standard deviation (MD) = - 0.38 %).
- MD of HbA1c was -0.3741 and -0.4596 mg/dl for DPP-4 inhibitors and SGLT-2 inhibitors respectively. Nine studies demonstrated differences in fasting plasma glucose (FPG) (MD = – 25,76) and 5 studies in post-prandial glucose (PPG) (MD = – 6.61) before and following treatment.
- Most studies did not show adverse effects on the glomerular filtration rate (GFR) and hepatic function.
"DPP-4 inhibitors and SGLT2 inhibitors appear both efficacious and safe in renal transplant recipients. More high-quality studies are required to guide therapeutic choices for PTDM," wrote the authors.
The study, "Incretin-Based Therapies and SGLT-2 Inhibitors in Kidney Transplant Recipients With Diabetes," is published in the journal Diabetes Research and Clinical Practice.
DOI: https://doi.org/10.1016/j.diabres.2020.108604
