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Diabetes Care. 2016 Jan;39(1):139-48. doi: 10.2337/dc15-0781. Epub 2015 Dec 1.

Alogliptin, a Dipeptidyl Peptidase 4 Inhibitor, Prevents the Progression of Carotid Atherosclerosis in Patients With Type 2 Diabetes: The Study of Preventive Effects of Alogliptin on Diabetic Atherosclerosis (SPEAD-A).

Author information

1
Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan Center for Molecular Diabetology, Juntendo University Graduate School of Medicine, Tokyo, Japan tom-m@juntendo.ac.jp.
2
Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Osaka, Japan Department of Metabolism and Atherosclerosis, Osaka University Graduate School of Medicine, Osaka, Japan.
3
Department of Medicine, Diabetology & Endocrinology, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan.
4
Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.
5
Naka Memorial Clinic, Ibaraki, Japan.
6
Shiraiwa Medical Clinic, Osaka, Japan.
7
Osaka Police Hospital, Osaka, Japan.
8
Osaka General Medical Center, Osaka, Japan.
9
Kansai Rosai Hospital, Hyogo, Japan.
10
Internal Medicine, Jiyugaoka Medical Clinic, Hokkaido, Japan.
11
Misaki Naika Clinic, Chiba, Japan.
12
Jinnouchi Hospital, Kumamoto, Japan.
13
Department of Clinical Trial and Clinical Epidemiology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.
14
Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan Center for Molecular Diabetology, Juntendo University Graduate School of Medicine, Tokyo, Japan Center for Therapeutic Innovations in Diabetes, Juntendo University Graduate School of Medicine, Tokyo, Japan.

Abstract

OBJECTIVE:

Recent experimental studies have shown that dipeptidyl peptidase 4 (DPP-4) inhibitors have antiatherosclerotic benefits in glucagon-like peptide 1-dependent and -independent manners. The current study investigated the effects of alogliptin, a DPP-4 inhibitor, on the progression of carotid atherosclerosis in patients with type 2 diabetes mellitus (T2DM).

RESEARCH DESIGN AND METHODS:

This prospective, randomized, open-label, blinded-end point, multicenter, parallel-group, comparative study included 341 patients with T2DM free of a history of apparent cardiovascular diseases recruited at 11 clinical units and randomly allocated to treatment with alogliptin (n = 172) or conventional treatment (n = 169). Primary outcomes were changes in mean common and maximum intima-media thickness (IMT) of the carotid artery measured by carotid arterial echography during a 24-month treatment period.

RESULTS:

Alogliptin treatment had a more potent glucose-lowering effect than the conventional treatment (-0.3 ± 0.7% vs. -0.1 ± 0.8%, P = 0.004) without an increase of hypoglycemia. Changes in the mean common and the right and left maximum IMT of the carotid arteries were significantly greater after alogliptin treatment than after conventional treatment (-0.026 mm [SE 0.009] vs. 0.005 mm [SE 0.009], P = 0.022; -0.045 mm [SE 0.018] vs. 0.011 mm [SE 0.017], P = 0.025, and -0.079 mm [SE 0.018] vs. -0.015 mm [SE 0.018], P = 0.013, respectively).

CONCLUSIONS:

Alogliptin treatment attenuated the progression of carotid IMT in patients with T2DM free of apparent cardiovascular disease compared with the conventional treatment.

PMID:
26628419
DOI:
10.2337/dc15-0781
[Indexed for MEDLINE]

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