PMID- 33269512
OWN - NLM
STAT- MEDLINE
DCOM- 20210708
LR  - 20210708
IS  - 1463-1326 (Electronic)
IS  - 1462-8902 (Linking)
VI  - 23
IP  - 3
DP  - 2021 Mar
TI  - The effects of dipeptidyl peptidase-4 inhibitors on kidney outcomes.
PG  - 763-773
LID - 10.1111/dom.14281 [doi]
AB  - AIMS: To summarize evidence from randomized controlled trials (RCTs) concerning 
      the effects of dipeptidyl peptidase-4 (DPP-4) inhibitors on kidney outcomes in 
      patients with type 2 diabetes mellitus (T2DM). METHODS: The Medline, EMBASE and 
      Cochrane databases were searched for RCTs comparing DPP-4 inhibitors with a 
      placebo, active comparator or standard care, with at least 500 person-years 
      follow-up in patients with T2DM and with reporting of kidney outcomes. Treatment 
      effects were summarized using random-effects meta-analysis. RESULTS: Ten trials 
      including 47 955 patients (mean estimated glomerular filtration rate [eGFR] 
      71 mL/min/1.73m(2) , mean follow-up 10 762 patient-years per trial) were eligible 
      for inclusion. DPP-4 inhibitors were compared with placebo (five trials), active 
      comparator (three trials), and standard care (two trials). Overall, treatment 
      with DPP-4 inhibitors was associated with a greater decline in eGFR than 
      treatment with the comparators (weighted mean difference -1.12 mL/min/1.73m(2) , 
      95% confidence interval [CI] -1.61, -0.62; high-certainty evidence). There were 
      no detectable effects of DPP-4 inhibitors on rates of doubling serum creatinine 
      (risk ratio [RR] 1.10, 95% CI 0.90, 1.34; high-certainty evidence), end-stage 
      kidney disease (RR 0.97, 95% CI 0.77, 1.23; high-certainty evidence), death from 
      kidney causes (RR 1.81, 95% CI 0.67, 4.93; low-certainty evidence), or all-cause 
      mortality (RR 1.01, 95% CI 0.95, 1.09; high-certainty evidence). DPP-4 inhibitors 
      significantly reduced the risks of the surrogate kidney outcome of new 
      albuminuria (RR 0.88, 95% CI 0.8, 0.98; moderate-certainty evidence) and 
      worsening albuminuria (RR 0.88, 95% CI 0.82, 0.94; moderate-certainty evidence). 
      There was no difference in the safety outcome of acute kidney injury (RR 1.04, 
      95% CI 0.57, 1.87; high-certainty evidence). CONCLUSIONS: Dipeptidyl peptidase-4 
      inhibitors are associated with a greater decline in eGFR, despite reducing the 
      development and progression of albuminuria, and have no clear effect on other key 
      kidney outcomes.
CI  - (c) 2020 John Wiley & Sons Ltd.
FAU - O'Hara, Daniel V
AU  - O'Hara DV
AUID- ORCID: 0000-0001-6066-8860
AD  - The George Institute for Global Health, UNSW, Sydney, Australia.
AD  - Renal Department, Royal North Shore Hospital, Sydney, Australia.
FAU - Parkhill, Thomas R
AU  - Parkhill TR
AD  - The George Institute for Global Health, UNSW, Sydney, Australia.
AD  - Renal Department, St George Hospital, Sydney, Australia.
FAU - Badve, Sunil V
AU  - Badve SV
AUID- ORCID: 0000-0003-2269-312X
AD  - The George Institute for Global Health, UNSW, Sydney, Australia.
AD  - Renal Department, St George Hospital, Sydney, Australia.
FAU - Jun, Min
AU  - Jun M
AUID- ORCID: 0000-0003-1460-7535
AD  - The George Institute for Global Health, UNSW, Sydney, Australia.
FAU - Jardine, Meg J
AU  - Jardine MJ
AUID- ORCID: 0000-0002-0160-2375
AD  - The George Institute for Global Health, UNSW, Sydney, Australia.
AD  - Renal Department, Concord Repatriation General Hospital, Sydney, Australia.
AD  - NHMRC Clinical Trials Centre, University of Sydney, Sydney, Australia.
FAU - Perkovic, Vlado
AU  - Perkovic V
AUID- ORCID: 0000-0002-4257-7620
AD  - The George Institute for Global Health, UNSW, Sydney, Australia.
AD  - Renal Department, Royal North Shore Hospital, Sydney, Australia.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
DEP - 20201229
PL  - England
TA  - Diabetes Obes Metab
JT  - Diabetes, obesity & metabolism
JID - 100883645
RN  - 0 (Dipeptidyl-Peptidase IV Inhibitors)
RN  - 0 (Hypoglycemic Agents)
RN  - EC 3.4.14.- (Dipeptidyl-Peptidases and Tripeptidyl-Peptidases)
SB  - IM
MH  - *Diabetes Mellitus, Type 2/complications/drug therapy
MH  - *Dipeptidyl-Peptidase IV Inhibitors/adverse effects
MH  - Dipeptidyl-Peptidases and Tripeptidyl-Peptidases
MH  - Humans
MH  - Hypoglycemic Agents/adverse effects
MH  - Kidney
OTO - NOTNLM
OT  - DPP-4 inhibitors
OT  - diabetes mellitus
OT  - kidney outcomes
EDAT- 2020/12/04 06:00
MHDA- 2021/07/09 06:00
CRDT- 2020/12/03 05:49
PHST- 2020/08/31 00:00 [received]
PHST- 2020/11/20 00:00 [revised]
PHST- 2020/11/30 00:00 [accepted]
PHST- 2020/12/04 06:00 [pubmed]
PHST- 2021/07/09 06:00 [medline]
PHST- 2020/12/03 05:49 [entrez]
AID - 10.1111/dom.14281 [doi]
PST - ppublish
SO  - Diabetes Obes Metab. 2021 Mar;23(3):763-773. doi: 10.1111/dom.14281. Epub 2020 
      Dec 29.