Effect of Anagliptin versus Sitagliptin on Renal Function: Subanalyzes from the REASON Trial

Hiroki Teragawa; Takeshi Morimoto; Yuichi Fujii; Tomohiro Ueda; Mio Sakuma; Michio Shimabukuro; Osamu Arasaki; Koichi Node; Takashi Nomiyama; Shinichiro Ueda

doi:10.2147/DMSO.S350518

Effect of Anagliptin versus Sitagliptin on Renal Function: Subanalyzes from the REASON Trial

Diabetes Metab Syndr Obes. 2022 Mar 3:15:685-694. doi: 10.2147/DMSO.S350518. eCollection 2022.

Authors

Affiliations

¹ Department of Cardiovascular Medicine, JR Hiroshima Hospital, Hiroshima, Japan.
² Department of Clinical Epidemiology, Hyogo College of Medicine, Nishinomiya, Japan.
³ Deparment of Diabetes, Endocrinology and Metabolism, Fukushima Medical University, Fukushima, Japan.
⁴ Department of Cardiology, Yuuai Medical Center, Tomigusuku, Okinawa, Japan.
⁵ Department of Cardiovascular Medicine, Saga University, Saga, Japan.
⁶ Department of Diabetes, Metabolism and Endocrinology, International University of Health and Welfare Ichikawa Hospital, Ichikawa, Japan.
⁷ Department of Clinical Pharmacology and Therapeutics, University of the Ryukyus, Nishihara, Okinawa, Japan.

Abstract

Purpose: The effects of two types of dipeptidyl peptidase-4 (DPP-4) inhibitors on renal function remain unclear. Thus, we investigated the effect of anagliptin (ANA) and sitagliptin (SITA) on renal function in patients with type 2 diabetes who participated in the randomized evaluation of ANA versus SITA on low-density lipoprotein-cholesterol (LDL-C) in diabetes (REASON) trial.

Patients and methods: We measured the estimated glomerular filtration rate (eGFR) and urinary albumin-creatinine ratio (UACR) before and after the REASON trial. ANA 200 mg/day was administered to 177 patients for 52 weeks, while SITA 50 mg/day was given to 176 patients. We investigated the relationship between differences in renal function and differences in hemoglobin A1c (HbA1c) levels, LDL-C levels, and blood pressure (BP).

Results: No significant differences were found in baseline eGFR and UACR between the two groups. The eGFR levels were significantly decreased in both groups; however, the UACR level was unchanged in the ANA group but elevated in the SITA group, although the difference did not reach significance between the two groups. The difference in eGFR was affected by the differences in HbA1c level and BP, and the difference in the UACR was affected by the differences in LDL-C level and BP, which were reduced only in the ANA group.

Conclusion: These findings imply that the effects of DPP-4 inhibitors on renal function, especially on UACR, may be different between the types of DPP-4 inhibitors.

Keywords: albuminuria; dipeptidyl peptidase 4; dipeptidyl peptidase 4 inhibitors; glomerular filtration rate.

Grants and funding

Kowa Company, Ltd. contributed to the REASON trial. Kowa had a representative participate in the research idea and evaluation of the final draft of the REASON trial’s main report. The academic authors, on the other hand, were exclusively responsible for the study design, operation, data collection, statistical analysis, and paper drafting.