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2.
CEN Case Rep ; 9(2): 141-146, 2020 05.
Artículo en Inglés | MEDLINE | ID: mdl-31950425

RESUMEN

Lipid abnormalities, including hypertriglyceridemia, are one of the most common comorbidities in patients with chronic kidney disease (CKD) and are independently associated with disease progression. However, it remains uncertain whether treatment for hypertriglyceridemia has favorable effects on the clinical course of IgA nephropathy (IgAN). Pemafibrate is a novel selective peroxisome proliferator-activated receptor-alpha modulator and may be distinct from conventional fibrates in terms of its pharmacological activity and hepatic and renal safety. A recent clinical study demonstrated that pemafibrate was safe and effective for correcting pro-atherogenic lipid abnormalities in CKD patients with a wide range of renal insufficiency. However, the effect of pemafibrate on renal function in patients with IgAN and hypertriglyceridemia has not been verified. This paper is the first to show that 12 months of pemafibrate (0.1 mg daily) administration in three drug-naïve and mild IgAN patients with variable renal dysfunction and histopathology proven IgAN decreased serum triglyceride level and excretion of urinary protein and liver-type fatty acid-binding protein with no change in estimated glomerular filtration rate (eGFR). These findings suggest that pemafibrate is safe and effective for correcting hypertriglyceridemia and decreasing urinary protein excretion without changing eGFR and blood pressure levels in mild IgAN patients with hypertriglyceridemia.


Asunto(s)
Benzoxazoles/farmacología , Butiratos/farmacología , Glomerulonefritis por IGA/tratamiento farmacológico , Hipertrigliceridemia/tratamiento farmacológico , Adulto , Aterosclerosis/tratamiento farmacológico , Aterosclerosis/metabolismo , Benzoxazoles/administración & dosificación , Benzoxazoles/uso terapéutico , Butiratos/administración & dosificación , Butiratos/uso terapéutico , Femenino , Tasa de Filtración Glomerular/efectos de los fármacos , Glomerulonefritis por IGA/complicaciones , Glomerulonefritis por IGA/metabolismo , Glomerulonefritis por IGA/orina , Humanos , Hipertrigliceridemia/complicaciones , Hipertrigliceridemia/metabolismo , Masculino , Persona de Mediana Edad , PPAR alfa/efectos de los fármacos , Proteínas/efectos de los fármacos , Proteínas/metabolismo , Proteinuria/prevención & control , Insuficiencia Renal/tratamiento farmacológico , Insuficiencia Renal/metabolismo , Insuficiencia Renal/fisiopatología , Resultado del Tratamiento
3.
Cardiovasc Diabetol ; 18(1): 158, 2019 11 16.
Artículo en Inglés | MEDLINE | ID: mdl-31733647

RESUMEN

BACKGROUND: Anagliptin, a dipeptidyl peptidase-4 inhibitor, is reported to reduce the level of low-density lipoprotein cholesterol (LDL-C). The underlying mechanism of this effect and effect on lipid metabolism however remains uncertain. AIM AND METHODS: We therefore evaluate the effects of anagliptin on lipid metabolism-related markers compared with those of sitagliptin. The study was a secondary analysis using data obtained from the Randomized Evaluation of Anagliptin versus Sitagliptin On low-density lipoproteiN cholesterol in diabetes (REASON) trial. This trial in patients with type 2 diabetes at a high risk of cardiovascular events and on statin therapy showed that anagliptin reduced LDL-C levels to a greater extent than sitagliptin. Cholesterol absorption (campesterol and sitosterol) and synthesis (lathosterol) markers were measured at baseline and 52 weeks in the study cohort (n = 353). RESULTS: There was no significant difference in the changes of campesterol or sitosterol between the two treatment groups (p = 0.85 and 0.55, respectively). Lathosterol concentration was increased significantly at 52 weeks with sitagliptin treatment (baseline, 1.2 ± 0.7 µg/mL vs. 52 weeks, 1.4 ± 1.0 µg/mL, p = 0.02), whereas it did not change in the anagliptin group (baseline, 1.3 ± 0.8 µg/mL vs. 52 weeks, 1.3 ± 0.7 µg/mL, p = 0.99). The difference in absolute change between the two groups showed a borderline significance (p = 0.06). CONCLUSION: These findings suggest that anagliptin reduces LDL-C level by suppressing excess cholesterol synthesis, even in combination with statin therapy. Trial registration ClinicalTrials.gov number NCT02330406. https://clinicaltrials.gov/ct2/show/NCT02330406; registered January 5, 2015.


Asunto(s)
LDL-Colesterol/sangre , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Inhibidores de la Dipeptidil-Peptidasa IV/uso terapéutico , Dislipidemias/tratamiento farmacológico , Inhibidores de Hidroximetilglutaril-CoA Reductasas/uso terapéutico , Pirimidinas/uso terapéutico , Fosfato de Sitagliptina/uso terapéutico , Anciano , Biomarcadores/sangre , Colesterol/análogos & derivados , Colesterol/sangre , Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/diagnóstico , Inhibidores de la Dipeptidil-Peptidasa IV/efectos adversos , Dislipidemias/sangre , Dislipidemias/diagnóstico , Femenino , Humanos , Inhibidores de Hidroximetilglutaril-CoA Reductasas/efectos adversos , Japón , Masculino , Persona de Mediana Edad , Fitosteroles/sangre , Pirimidinas/efectos adversos , Fosfato de Sitagliptina/efectos adversos , Sitoesteroles/sangre , Factores de Tiempo , Resultado del Tratamiento
4.
Geriatr Gerontol Int ; 18(4): 631-639, 2018 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-29314506

RESUMEN

AIM: The aim of the present study was to assess the efficacy and safety of sitagliptin in elderly patients with type 2 diabetes mellitus. METHODS: A total of 188 patients were enrolled who had type 2 diabetes mellitus with poor glycemic profiles (hemoglobin A1c [HbA1c] ≥6.2%). Patients were assigned to one of three age groups (<65, 65-74 and ≥75 years) and received 50-100 mg of sitagliptin daily for 12 months. Changes in HbA1c classified by age and body mass index (BMI) were assessed in addition to physiological parameters. RESULTS: Mean HbA1c decreased significantly in all age groups (<65 years 8.01 ± 1.59% to 7.29 ± 1.23%; 65-74 years 7.61 ± 1.11% to 7.05 ± 0.99%; ≥75 years 7.21 ± 0.87% to 6.74 ± 0.96%). Reductions in HbA1c were not significantly different among age groups (P = 0.324). In older patients aged 65-74 years and ≥75 years, HbA1c decreased significantly in lean (BMI <25 kg/m2 ) patients (7.52 ± 1.10% to 6.99 ± 1.08%; P < 0.001) and in obese (BMI ≥25 kg/m2 ) patients (7.25% ± 0.90% to 6.86% ± 0.86%; P = 0.015); the changes in HbA1c were not significantly different between the lean and the obese groups (P = 0.943). Adverse events occurred in 12 patients (10.3%) aged ≥65 years, although there was no significant difference among the three age groups. CONCLUSIONS: Sitagliptin treatment offers elderly patients aged ≥65 years efficacious and safe reductions in HbA1c values regardless of BMI. Geriatr Gerontol Int 2018; 18: 631-639.


Asunto(s)
Diabetes Mellitus Tipo 2/tratamiento farmacológico , Fosfato de Sitagliptina/uso terapéutico , Anciano , Glucemia , Índice de Masa Corporal , Hemoglobina Glucada , Humanos , Fosfato de Sitagliptina/efectos adversos , Resultado del Tratamiento
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