Long-term efficacy of vildagliptin in patients with type 2 diabetes undergoing hemodialysis

Abstract

BackgroundThere are few studies evaluating long-term glycemic control using a dipeptidyl peptidase-4 inhibitor in type 2 diabetes patients with end-stage renal disease (ESRD). The aim of this study was to evaluate the safety and efficacy of vildagliptin therapy over 2 years in type 2 diabetes with ESRD.MethodsPatients with ESRD resulting from type 2 diabetes requiring dialysis who had ≥20 % glycated albumin (GA) were enrolled. Vildagliptin 50 mg once daily was administered for 2 years. Changes in GA and dry weight were evaluated.ResultsIn 32 patients (24 men and 8 women) aged 68.3 ± 1.9 years, vildagliptin 50 mg once daily was administered for 2 years, but the dose was increased to 50 mg twice daily in 15 patients. GA was significantly reduced by 2.6 ± 0.6 %, from 22.4 ± 0.6 % at baseline to 19.8 ± 0.4 % at 2 years. After 2 years of vildagliptin therapy, 15 (46.9 %) of 32 patients achieved a GA level of <20 %. Dry weight changed slightly, with an increase of 1.3 ± 0.8 kg at 2 years. No adverse drug reactions related to treatment with vildagliptin were seen.ConclusionsVildagliptin is a promising therapeutic option for safe, effective glycemic control in type 2 diabetic patients with ESRD.

Efficacy of different dipeptidyl peptidase-4 (DPP-4) inhibitors on metabolic parameters in patients with type 2 diabetes undergoing dialysis

“… [25] In patients with severe degrees of renal impairment (creatinine clearance <30 mL/min), the AUC is about doubled. [26] Even though 400 or 600 mg daily was associated with some adverse effects, such as peripheral edema, paresthesia, and elevated serum concentrations of aspartate aminotransferase, there were no related side effects of high dose of vildagliptin in 2 previous reports (200 mg daily)[ 10 16 ] and in this study (50 mg bid).…”

“… [9] Vildagliptin, another DPP-4 inhibitor proven to be an option for effective glycemic control in ESRD patients, has an adjusted dose of 50 mg/day in ESRD patients compared with the 100 mg/day full dose for those with normal renal function. [10] The DPP-4 inhibitor linagliptin has a very low renal elimination profile, so dose adjustment is not required for patients whose kidney function is impaired, and many physicians prescribe it widely. [11] In patients with normal kidney function, the effects of DPP-4 inhibitors on the plasma glucose level and glycemic indices generally seem to be similar.…”

The Role of DPP-4 Inhibitors in Diabetological Care

“…Побочных эффектов, связанных с лечением вилдаглиптином, не отмечалось. Таким образом, вилдаглиптин является безопасным препаратом у пациентов с СД2 и ХПН [29].…”

Dipeptidyl Peptidase-4 Inhibitor Development and Post-authorisation Programme for Vildagliptin – Clinical Evidence for Optimised Management of Chronic Diseases Beyond Type 2 Diabetes

“…As a result, detailed pharmacokinetic (PK) studies were performed with all agents, 49 followed by clinically meaningful studies, even in high doses, particularly in Asian patients undergoing haemodialysis. 50 …”