Alogliptin, a Dipeptidyl Peptidase 4 Inhibitor, Prevents the Progression of Carotid Atherosclerosis in Patients With Type 2 Diabetes: The Study of Preventive Effects of Alogliptin on Diabetic Atherosclerosis (SPEAD-A)

Abstract

OBJECTIVERecent experimental studies have shown that dipeptidyl peptidase 4 (DPP-4) inhibitors have antiatherosclerotic benefits in glucagon-like peptide 1-dependent and -independent manners. The current study investigated the effects of alogliptin, a DPP-4 inhibitor, on the progression of carotid atherosclerosis in patients with type 2 diabetes mellitus (T2DM). RESEARCH DESIGN AND METHODSThis prospective, randomized, open-label, blinded-end point, multicenter, parallelgroup, comparative study included 341 patients with T2DM free of a history of apparent cardiovascular diseases recruited at 11 clinical units and randomly allocated to treatment with alogliptin (n = 172) or conventional treatment (n = 169). Primary outcomes were changes in mean common and maximum intima-media thickness (IMT) of the carotid artery measured by carotid arterial echography during a 24-month treatment period. RESULTSAlogliptin treatment had a more potent glucose-lowering effect than the conventional treatment (20.3 6 0.7% vs. 20.1 6 0.8%, P = 0.004) without an increase of hypoglycemia. Changes in the mean common and the right and left maximum IMT of the carotid arteries were significantly greater after alogliptin treatment than after conventional treatment (20.026 mm [SE 0.009] CONCLUSIONSAlogliptin treatment attenuated the progression of carotid IMT in patients with T2DM free of apparent cardiovascular disease compared with the conventional treatment.

Factors Contributing to Progression of Glomerulonephritis and Cardiovascular Disorders

“…Так, име-ются данные, что гипер-и дислипидемия часто ассоци-ируются с ростом уровня СРБ, т.е. имеет место содру-жественное течение [17,18].…”

Second line therapy in type 2 diabetes: legacy effect activation

“…Для изучения влияния сахароснижающей терапии на конеч-ные точки (смертность, инфаркт миокарда, острое наруше-ние мозгового кровообращения (ОНМК)) у лиц без исходных ССЗ должны пройти десятилетия, поэтому среди данной ко-горты больных чаще изучаются факторы риска или суррогат-ные точки. В частности получены результаты исследования SPEAD-A, изучавшего влияние сахароснижающей терапии на толщину комплекса интима-медиа [37]. В данном иссле-довании применение иДПП-алоглиптина позволяло более значимо предотвращать прогрессию утолщения комплекса интима-медиа по сравнению с другими сахароснижающими препаратами у лиц без ССЗ в ана мнезе.…”

Incretin-Based Therapies for Diabetic Complications: Basic Mechanisms and Clinical Evidence

“…Recent studies have shown that aloglitpin and sitagliptin prevent the progression of carotid atherosclerosis in patients with diabetes [97,98]. Furthermore, a meta-analysis demonstrated that GLP-1-based therapy has beneficial effects on atherosclerotic markers (brain naturetic peptide, high-sensitivity C-reactive protein, plasminogen activator inhibitor-1, total cholesterol, LDL cholesterol, and triglycerides) in patients with type 2 diabetes [99].…”