The Effects of Novel Antidiabetic Drugs on Albuminuria in Type 2 Diabetes Mellitus: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Luo, Yuejun; Lü, Kai; Liu, Gang; Wang, Jing; Laurent, Irakoze; Zhou, Xiaoli

doi:10.1007/s40261-018-0707-4

Cited by 15 publications

(28 citation statements)

References 84 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Large outcome studies, conducted for five DPP4 inhibitors to date, confirmed safety, but interestingly showed no significant cardiovascular benefit (Nauck et al, 2017;McGuire et al, 2019). Furthermore, no signals suggesting a renal benefit were detected in a meta-analysis of outcomes studies conducted to date (Luo et al, 2018).…”

Section: Gip and Dual Gip/glp-1 Receptor Agonistsmentioning

confidence: 95%

“…The majority of GLP-1 receptor agonists shows a cardiovascular benefit, as evidenced by a decrease in the composite endpoint of myocardial infarction, stroke, and cardiovascular death (Hernandez et al, 2018;Marso et al, 2016aMarso et al, , 2016bNauck et al, 2017;Gerstein et al, 2019). In addition, a decrease in albuminuria and a slower decline in glomerular filtration rate was observed in several studies, raising the possibility of renal benefits (Luo et al, 2018;Mann et al, 2017;Tuttle et al, 2018;Gerstein et al, 2019). The mechanisms underlying these benefits are not clear.…”

Section: Glp-1 Receptor Agonistsmentioning

confidence: 97%

See 1 more Smart Citation

Leveraging the Gut to Treat Metabolic Disease

2020

View full text Add to dashboard Cite

25 years ago, the future of treating obesity and diabetes focused on end organs known to be involved in energy balance and glucose regulation, including the brain, muscle, adipose tissue, and pancreas. Today, the most effective therapies are focused around the gut. This includes surgical options, such as vertical sleeve gastrectomy and Roux-en-Y gastric bypass, that can produce sustained weight loss and diabetes remission but also extends to pharmacological treatments that simulate or amplify various signals that come from the gut. The purpose of this Review is to discuss the wealth of approaches currently under development that seek to further leverage the gut as a source of novel therapeutic opportunities with the hope that we can achieve the effects of surgical interventions with less invasive and more scalable solutions.

show abstract

Section: Gip and Dual Gip/glp-1 Receptor Agonistsmentioning

confidence: 95%

Section: Glp-1 Receptor Agonistsmentioning

confidence: 97%

Leveraging the Gut to Treat Metabolic Disease

2020

View full text Add to dashboard Cite

show abstract

“…A previous global meta-analysis showed that compared with other traditional therapies or placebos, SGLT2 inhibitors may reduce albuminuria and significantly benefit renal composite endpoint events [47]. They may also improve renal hemodynamics, reduce glomerular ultrafiltration and intrarenal pressure, and reduce albuminuria [41].…”

Section: Discussionmentioning

confidence: 99%

Renal outcomes in Asian patients with type 2 diabetes mellitus treated with SGLT2 inhibitors: a systematic review and meta-analysis of randomized controlled trials

Zhao

Zhou

Tao

et al. 2021

Int J Diabetes Dev Ctries

View full text Add to dashboard Cite

Aim This study investigated the effects of sodium-glucose cotransporter 2 (SGLT2) inhibitors on renal outcomes in Asian patients with type 2 diabetes mellitus (T2DM). Materials and methods We searched Medline, EMBASE, and the Cochrane Library to identify randomized controlled trials published up to April 2020 that compared SGLT2 inhibitors with placebo or active comparator and reported any renal outcomes in Asian patients with T2DM. Random effects models and inverse variance weighting were used to calculate relative risks with 95% confidence intervals (CIs). Results We included 14 studies, totaling 3792 patients, in the analysis. In the short term, SGLT2 inhibitors significantly slowed estimated glomerular filtration rate (eGFR) decline (MD: 0.80; 95% CI: 0.66 to 0.94; p < 0.00001) and reduced Scr levels (SMD: − 0.17; 95% CI: − 0.23 to − 0.10; p < 0.00001) as compared with the control groups. The SGLT2 inhibitor group also had an advantage over the control group in lowering uric acid (UA) (SMD: − 1.2; 95% CI: − 1.30 to − 1.11; p < 0.00001). There was no significant difference in urinary albumin creatinine ratio (UACR) reduction between the SGLT2 inhibitor and control groups (MD: − 8.87; 95% CI: − 19.80 to 2.06; p = 0.11). However, dapagliflozin does appear to reduce albuminuria (p = 0.005). Lastly, SGLT2 inhibitors increased the incidence of adverse events (AEs) related to renal function (OR: 1.90; 95% CI: 1.24 to 2.91; p = 0.003), but did not increase the incidence of renal impairment (OR: 0.85; 95% CI: 0.40 to 1.81; p = 0.68). Conclusion The use of SGLT2 inhibitors in Asian patients with T2DM can help delay the decline of eGFR and reduce Scr and UA. Although SGLT2 inhibitors have no overall advantage in reducing albuminuria, dapagliflozin does appear to reduce albuminuria, and while they may increase the occurrence of AEs related to renal function, they do not increase the incidence of renal impairment.

show abstract

“…DPP-4 inhibition is a predominant approach for treating diabetes because of prolonged incretin half-lives within serum, especially in type 2 DM. 69 In addition, it has been suggested that sitagliptin can preserve pancreatic β-cell function and subsequently stabilize insulin secretion as shown by two 4-year clinical trials, in which sitagliptin was adopted to treat slowly progressive type 1 DM (SPTIDDM) and latent autoimmune diabetes adult (LADA). 55,70 In addition to clinical treatment, DPP-4 levels can be used as a biomarker.…”

Section: Role Of Dpp-4 In Diabetes Treatmentmentioning

confidence: 99%

The perceptions of natural compounds against dipeptidyl peptidase 4 in diabetes: from in silico to in vivo

Lin

Tsai

Cheng

et al. 2019

Therapeutic Advances in Chronic Disease

View full text Add to dashboard Cite

Dipeptidyl peptidase IV (DPP-4), an incretin glucagon-like peptide-1 (GLP-1) degrading enzyme, contains two forms and it can exert various physiological functions particular in controlling blood glucose through the action of GLP-1. In diabetic use, the DPP-4 inhibitor can block the DDP-4 to attenuate GLP-1 degradation and prolong GLP-1 its action and sensitize insulin activity for the purpose of lowering blood glucose. Nonetheless the adverse effects of DPP-4 inhibitors severely hinder their clinical applications, and notably there is a clinical demand for novel DPP-4 inhibitors from various sources including chemical synthesis, herbs, and plants with fewer side effects. In this review, we highlight various strategies, namely computational biology ( in silico), in vitro enzymatic and cell assays, and in vivo animal tests, for seeking natural DPP-4 inhibitors from botanic sources including herbs and plants. The pros and cons of all approaches for new inhibitor candidates or hits will be under discussion.

show abstract

The Effects of Novel Antidiabetic Drugs on Albuminuria in Type 2 Diabetes Mellitus: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Cited by 15 publications

References 84 publications

Leveraging the Gut to Treat Metabolic Disease

Leveraging the Gut to Treat Metabolic Disease

Renal outcomes in Asian patients with type 2 diabetes mellitus treated with SGLT2 inhibitors: a systematic review and meta-analysis of randomized controlled trials

The perceptions of natural compounds against dipeptidyl peptidase 4 in diabetes: from in silico to in vivo

Contact Info

Product

Resources

About