Efficacy and safety of saxagliptin in type 2 diabetic patients undergoing hemodialysis

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  • 2型糖尿病合併血液透析患者に対するサキサグリプチンの有効性と安全性の検討
  • 2ガタ トウニョウビョウ ガッペイ ケツエキ トウセキ カンジャ ニ タイスル サキサグリプチン ノ ユウコウセイ ト アンゼンセイ ノ ケントウ

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[Background and objectives] This prospective, open-label study was aimed at investigating the efficacy and safety of the dipeptidyl peptidase-IV (DPP-4) inhibitor saxagliptin in patients with type 2 diabetes mellitus undergoing hemodialysis. [Design, setting, participants, & measurements] Thirteen patients with type 2 diabetes mellitus and serum glycoalbumin of ≥20% were selected to participate in this 3-month study (11 men, 2 women, age 59.3±14.8 years, hemodialysis duration 8.2±5.5). All of the patients were undergoing hemodialysis therapy 3 times a week at one of our hospitals. Saxagliptin was administered (2.5 mg/day) for the 3-month study period. In the three patients who were already on a DPP-4 inhibitor (2 patients on alogliptin and 1 on linagliptin), the treatment was switched to saxagliptin (2.5 mg/day). We evaluated casual plasma glucose (PG), hemoglobin A1c (HbA1c), and gylcoalbumin (GA), among others, in the patients. [Results] Two patients were excluded : One had heart failure and needed the addition of insulin, and the other developed nausea after the start of treatment with saxagliptin and wanted to drop out of the study. PG was significantly decreased at 1 month and 2 months after the start of saxagliptin administration (from 201±46 mg/dL to 158±40 mg/dL, and to 155±45 mg/dL, respectively ; p<0.05). Decrease of PG was also observed at 3 months after the start of treatment, although the difference did not reach statistical significance (to 167±61 mg/dL, p=0.0527). Significant decreases of both HbA1c and GA were observed at 1, 2, and 3 months after the start of treatment (from 6.8±1.1% to 6.5±1.0%, 6.5±0.9%, and 6.6±0.9%, and from 25.1±3.4% to 23.2±2.8%, 22.7±3.3%, and 22.9±2.6%, p<0.05, respectively). [Conclusion] No serious adverse effects such as hypoglycemia or liver dysfunction were observed in any of the patients. Thus, saxagliptin appears to be an effective treatment for diabetic patients undergoing HD.

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