Efficacy and safety of alogliptin in type 2 diabetic patients undergoing hemodialysis

Abstract

This prospective, open-label study aimed to investigate the efficacy and safety of the dipeptidyl peptidase-IV inhibitor alogliptin in patients with type 2 diabetes undergoing hemodialysis (HD). Twenty-eight patients with chronic type 2 diabetes (22 men, 6 women) were selected to participate in this 24-week study from patients undergoing 4-h sessions of HD therapy 3 times weekly at the blood purification units of our hospitals. All patients had oliguria or anuria, poor glycemic control, and none were receiving insulin treatment. Poor glycemic control was defined as a hemoglobin A1c (HbA1c) level exceeding 6.9% and/or a glycated albumin (GA) level exceeding 20.0% after 8 consecutive weeks of the daily administration of conventional therapy (dietary therapy alone or mitiglinide and/or voglibose). Alogliptin was administered (6.25 mg/day) for the 24-week study period. Significant decreases were observed in postprandial plasma glucose (PPG), HbA1c, and GA levels after the start of alogliptin therapy, and these levels continued to decrease throughout the 24-week treatment period. After 24 weeks, alogliptin had decreased the mean HbA1c level from 7.1% at baseline to 6.2%, the mean GA level from 25.9% at baseline to 21.0%, and the mean PPG level from 217 mg/dL at baseline to 156 mg/dL (all p<0.0001). The efficacy of alogliptin did not differ according to age or body mass index; however, significantly larger reductions in PPG and GA levels were observed in the anti-diabetic agents-naïve group. No serious adverse effects such as hypoglycemia or liver impairment were observed in any of the patients. Alogliptin appears to be an effective treatment for diabetic patients undergoing HD.