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KMID : 0356620160310010161
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Journal of Korean Society of Endocrinology
2016 Volume.31 No. 1 p.161 ~ p.167
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Effects of Dipeptidyl Peptidase-4 Inhibitors on Hyperglycemia and Blood Cyclosporine Levels in Renal Transplant Patients with Diabetes: A Pilot Study
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:Bae Jae-Hyun
:Lee Min-Jung/:Choe Eun-Yeong/:Jung Chang-Hee/:Wang Hye-Jin/:Kim Myoung-Soo/:Kim Yu-Seun/:Park Joong-Yeol/:Kang Eun-Seok
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Abstract
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Background : The use of dipeptidyl peptidase-4 (DPP-4) inhibitors is increasing among renal transplant patients with diabetes. However, the glucose-lowering efficacies of various DPP-4 inhibitors and their effects on blood cyclosporine levels have not been fully investigated. We compared the glucose-lowering efficacies of DPP 4 inhibitors and evaluate their effects on the blood levels of cyclosporine in renal transplant recipients with diabetes.
Methods : Sixty-five renal allograft recipients who received treatment with DPP-4 inhibitors (vildagliptin, sitagliptin, or linagliptin) following kidney transplant were enrolled. The glucose-lowering efficacies of the DPP-4 inhibitors were compared according to the changes in the hemoglobin A1c (HbA1c) levels after 3 months of treatment. Changes in the trough levels of the cyclosporine were also assessed 2 months after treatment with each DPP-4 inhibitor.
Results : HbA1c significantly decreased in the linagliptin group in comparison with other DPP-4 inhibitors (vildagliptin ?0.38%±1.03%, sitagliptin ?0.53%±0.95%, and linagliptin ?1.40±1.34; P=0.016). Cyclosporine trough levels were significantly increased in the sitagliptin group compared with vildagliptin group (30.62±81.70 ng/mL vs. ?24.22±53.54 ng/mL, P=0.036). Cyclosporine trough levels were minimally changed in patients with linagliptin.
Conclusion : Linagliptin demonstrates superior glucose-lowering efficacy and minimal effect on cyclosporine trough levels in comparison with other DPP-4 inhibitors in kidney transplant patients with diabetes.
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KEYWORD
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Dipeptidyl-peptidase IV inhibitors, Sitagliptin phosphate, Vildagliptin, Linagliptin, Cyclosporine, Kidney transplantation, Diabetes mellitus
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