December 31, 2015
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Nesina may slow carotid atherosclerosis in type 2 diabetes

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In patients with type 2 diabetes without cardiovascular disease, treatment with the DPP-IV inhibitor Nesina appears to diminish the progression of carotid intima-media thickness, according to data from the SPEAD-A trial.

Researchers evaluated 341 patients with type 2 diabetes seen at outpatient clinics at 11 institutions in Japan. Participants had no apparent CVD, secondary diabetes, moderate or severe renal dysfunction or kidney dysfunction. Participants were randomly assigned Nesina (alogliptin, Takeda Pharmaceuticals; n = 172) or conventional treatment with drugs other than DPP-IV inhibitors (n = 169).

The study’s primary outcome was change in intima-media thickness during the 104-week study interval as assessed by carotid arterial echography. Secondary endpoints included changes in glycemic control parameters, changes in diabetic nephropathy measures, changes in lipid parameters, changes in biochemical parameters, occurrence of CV events and occurrence of any adverse events.

During 104 weeks, alogliptin treatment significantly decreased the mean intima-media thickness of the common carotid artery compared with conventional treatment (P = .022). Compared with conventional treatment, alogliptin also significantly reduced the right maximum intima-media thickness (P = .025) and the left maximum intima-media thickness (P = .013) of the carotid arteries. Moreover, alogliptin had a more substantial effect on glucose reduction compared with conventional treatment (P = .004) without an accompanying increase in hypoglycemia.

“Alogliptin treatment attenuated the progression of carotid [intima-media thickness] in patients with [type 2 diabetes] free of a history of apparent CVD compared with the conventional treatment,” the researchers wrote. “A large-scale prospective trial is required to establish the usefulness of DPP-IV inhibitors for primary prevention of CVD in patients with [type 2 diabetes].” – by Jennifer Byrne

Disclosure: The study was funded in part by Astellas Pharma, AstraZeneca, Bayer Holding, Daiichi Sankyo, Eli Lilly Japan, Merck, Sharp & Dohme, Nippon Boehringer Ingelheim, Novartis Pharma, Novo Nordisk, Pfizer Japan Inc., Sanofi, Sanwa Kagaku Kenkyusho, Shionogi & Co. Ltd., Sumitomo Dainippon Pharma Co. and Takeda Pharmaceutical. Please see the full study for a list of all authors’ relevant financial disclosures.