Published online Oct 15, 2018. doi: 10.4239/wjd.v9.i10.165
Peer-review started: June 25, 2018
First decision: July 9, 2018
Revised: July 12, 2018
Accepted: August 26, 2018
Article in press: August 26, 2018
Published online: October 15, 2018
Processing time: 110 Days and 7.6 Hours
Dipeptidyl peptidase-4 (DPP-4) inhibitors are extensively used in patients with type 2 diabetes mellitus (T2DM). DPP-4 inhibitors can improve dyslipidemia and hypertension in addition to glycemic control.
Anagliptin is a unique DPP-4 inhibitor that possibly reduces the low-density lipoprotein cholesterol levels; however, it is not commonly available outside Japan. Few studies have directly compared the efficacy of anagliptin with other gliptins in the management of T2DM.
To assess the comparative effectiveness of anagliptin and linagliptin on the glycemic control, blood pressure, lipid profile, and liver and renal function in Japanese patients with T2DM.
A 2-year retrospective cohort study in a diabetes-specialty clinic.
Both anagliptin and linagliptin effectively improved glycemic control for 2 years. Interestingly, diastolic blood pressure was reduced following the administration of anagliptin, and serum high-density lipoprotein cholesterol levels were increased following the administration of linagliptin. However, no significant changes in serum low-density lipoprotein cholesterol levels were observed in both the anagliptin group and the linagliptin group.
This study adds to the current literature supporting that the efficacy of DPP-4 inhibitors on metabolic parameters may differ between anagliptin and linagliptin. Both DPP-4 inhibitors may have a unique effect beyond the class effect of DPP-4 inhibitors. However, whether a substantial clinical difference exists in the effect of DPP-4 inhibitors on metabolic parameters is still inconclusive because this study is a retrospective cohort study.
We suggest the need for well-designed, large-scale studies to elucidate the effect of DPP-4 inhibitors on metabolic parameters beyond the glucose-lowering effect. Furthermore, comparative efficacy of DPP-4 inhibitors for arterial stiffness should also be investigated in the future.