In a nutshell
This study aimed to determine the effectiveness and safety of linagliptin treatment in patients with mild and moderate kidney dysfunction.
Approximately 40% of diabetics develop kidney disease. This is associated with a higher risk of developing cardiovascular dysfunction (heart-related illness) and mortality (death) in general. Kidney disease can also impair drug filtration, prolonging the duration of drugs in the blood. This can lead to hypoglycemia (abnormally low blood sugar levels) and other adverse events. Some studies have shown that linagliptin, unlike similar drugs such as saxagliptin (Onglyza), sitagliptin (Januvia) and vildagliptin (Xiliarx, Jalra, Galvus), is less likely to cause this effect. Furthermore, it has also been shown that it is still effective at lowering HbA1c levels (a measure of blood glucose [sugar]).
Methods & findings
This large-scale clinical trial aimed to further test the effectiveness and safety of linagliptin. The data from 2,143 patients from a total of three studies was collected and analyzed. Patients were grouped according to kidney function – normal, mild impairment and moderate impairment. Each group consisted of patients who were treated with linagliptin and patients who were treated with a placebo (a drug with no therapeutic effect, used as a control). HbA1c was measured in all three groups.
A reduction of HbA1c (above 6.5% is classed as diabetic) of 0.63% was observed in patients with normal kidney function. Similar reductions were observed in patients with mild (0.67%) and moderate (0.53%) kidney function impairment. Though hypoglycemia was slightly more frequent in those taking linagliptin, this was not significant. No significant difference was found between the groups in the frequency of overall adverse events.
The bottom line
The authors concluded that linagliptin is an effective and safe choice for diabetic patients with kidney disease.
The fine print
Some patients were being treated with linagliptin alone while others were treated with linagliptin and metformin (Glucophage) and some patients were treated with linagliptin, metformin and a different type of drug. No comparisons were made between the effect of these different drug combinations on efficacy and safety. Additionally, cases of severe kidney dysfunction were excluded so the results may not be relevant to this group.
Consult your doctor if you are concerned about how your kidney dysfunction may effect the effectiveness or safety of your diabetes drugs.
Published By :
Diabetes, Obesity and Metabolism
Feb 26, 2014
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