Κατεύθυνση Αναζωογόνηση
Library of the School of Health Sciences

2019-02-04

2019

Tsoumidi Kalliopi

Πουρνάρας Σπυρίδων, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ, Επιβλέπων
Κουσκούνη Ευαγγελία, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Ιακωβίδου Νικολέττα, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ

Σύγκριση της επίδρασης των DPP-4 αναστολέων με τους GLP-1 αγωνιστές στη μεταβολή καρδιαγγειακών παραγόντων κινδύνου σε άτομα με Σακχαρώδη Διαβήτη τύπου 2 υπό Ινσουλινοθεραπεία. Στοχαστικό μοντέλο φαρμακο-οικονομικής αξιολόγησης.

Greek

Comparison between DPP-4 inhibitors and GLP-1 agonists on their efficacy to modify cardiovascular risk factors in patients with diabetes mellitus under insulin therapy. Stochastic model of pharmaco-economic evaluation.

Background: Therapeutic antidiabetic options include drug categories that have
positive effects not only in management of hyperglycemia, but also against other
cardiovascular risk factors such as hypertension, body weight and dyslipidemia. Such
drugs that present these features and are based on the incretin effect are GLP-1
(Glucagon Like Peptide -1) agonists and DPP-4 (Dipeptidyl Peptidase - 4) inhibitors.
Objective: To compare the efficacy of DPP-4 inhibitors and GLP-1 agonists on the
modification of cardiovascular risk factors in patients with diabetes mellitus under
insulin therapy.
Methods: 579 patients of the Center for Diabetes of General Hospital of Nikaia-Piraeus
were included in the trial, who received either DPP-4 inhibitor or GLP-1 agonist.
Necessary changes of their concomitant medication have been made according to
guidelines. All their characteristics (somatometric, clinical, laboratory) were estimated
in the beginning, in the middle and in the end of the observation period which was 52±2
weeks.
Results: 284 patients (49.1%) received GLP-1 agonist with their concomitant
medications and 295 (50.9%) received DPP-4 inhibitor. GLP-1 agonists resulted in
greater possibility of statistically significant reduction of body weight after 12 months
(HR=8.56, 95% CI:1.43-4.28, p<0.0001), significant effect in HbA1c (HR=2.58, 95%
CI:1.15-2.38, p=0.001) and in fasting glucose (HR=2.99, 95% CI: 1.39-4.31, p=0.012)
compared to DPP-4 inhibitors. Moreover, GLP-1 agonists affect more positively LDL
cholesterol (HR=1.34, 95% CI:1.31-3.82, p=0.011), total cholesterol (HR=1.19, 95%
CI:1.09-2.97, p=0.041), triglycerides (HR=1.15, 95% CI:1.07-4.12, p=0.045) and
systolic blood pressure (HR=1.22, 95% CI:1.05-3.18, p=0.048), with neutral effect in
diastolic blood pressure and HDL cholesterol.
Conclusions: GLP-1 agonists compared to DPP-4 inhibitors appear to have a more
positive effect on cardiovascular risk factors.

Health Sciences

GLP-1 agonists, DPP-4 inhibitors, Diabetes mellitus, Cardiovascular disease, hypertension

No

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Yes

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https://pergamos.lib.uoa.gr/uoa/dl/object/2847339