Add-On Therapy with DPP-4 Inhibitors May Improve Renal Function Decline in α-Glucosidase Inhibitor and Metformin Users: A Retrospective Observational Study.

We retrospectively evaluated the long-term effect of dipeptidyl peptidase (DPP)-4 inhibitors on estimated glomerular filtration rate (eGFR) slopes, and then evaluated the beneficial interaction between DPP-4 inhibitor initiation and baseline use of α-glucosidase inhibitor and/or metformin in patients with diabetic kidney disease. Altogether, 1512 patients with type 2 diabetes were receiving DPP-4 inhibitor therapy over 1 year and were followed up for a maximum of 2 years before and after 7 years of treatment. The decline in renal function was estimated as the slope of the individual linear regression line of eGFR over 2-year follow-up. Prescription data on medications before and after DPP-4 inhibitor treatment were examined. The mean length of DPP-4 inhibitor treatment was 5.3 ± 2.6 years. The baseline mean eGFR slope (mL/min/1.73m In the present study, patients treated with DPP-4 inhibitors had a significantly slower annual loss of kidney function. The benefit appears pronounced in α-glucosidase inhibitor and metformin users with advanced renal dysfunction. These results suggest that the beneficial effects of DPP-4 inhibitors on kidney function may have occurred in the presence of an α-glucosidase inhibitor and/or metformin.

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© 2020 Osonoi et al.

Déclaration de conflit d'intérêts

T.O. received personal fees from Abbott, AbbVie GK, Astellas Pharma, AstraZeneca, Bayer Yakuhin, Bristol-Myers Squibb, Daiichi Sankyo, Eli Lilly, Japan Tobacco, Kowa Pharmaceutical, Kyowa Hakko Kirin, Mitsubishi Tanabe Pharma, MSD, Novo Nordisk Pharma, Novartis Pharma, Ono Pharmaceutical, Poxel SA, Sanofi, Sanwa Kagaku Kenkyusho, Sumitomo Dainippon Pharma, Takeda Pharmaceutical, and Terumo, outside the submitted work and reports no other potential conflicts of interest for this work. The other authors report no conflicts of interest for this work.