Effect of sitagliptin on kidney function and respective cardiovascular outcomes in type 2 diabetes: Outcomes from TECOS.Reportar como inadecuado




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Reference: Cornel, JH, Bakris, GL, Stevens, SR et al., (2016). Effect of sitagliptin on kidney function and respective cardiovascular outcomes in type 2 diabetes: Outcomes from TECOS. Diabetes Care.Citable link to this page:

 

Effect of sitagliptin on kidney function and respective cardiovascular outcomes in type 2 diabetes: Outcomes from TECOS.

Abstract: ObjectiveTo evaluate chronic kidney disease (CKD) and cardiovascular outcomes in TECOS participants with type 2 diabetes and cardiovascular disease treated with sitagliptin, a dipeptidyl peptidase-4 inhibitor (DPP-4i), according to baseline estimated glomerular filtration rate (eGFR).Research Design and MethodsWe used data from 14,671 TECOS participants assigned double-blind to receive sitagliptin or placebo added to existing therapy, whilst aiming for glycemic equipoise between groups. Cardiovascular and CKD outcomes were evaluated over median of 3 years, with participants categorized at baseline into eGFR stages 1, 2, 3a and 3b (≥90, 60-89, 45-59 or 30-44 ml/min/1.73m2, respectively).ResultsParticipants with eGFR stage 3b were older, more often female and had longer diabetes duration. Four-point MACE rates increased with lower baseline eGFR (3.52, 3.55, 5.74 and 7.34 events per 100 patient-years for stages 1-3b, respectively. Corresponding adjusted hazard ratios (95% CI) for stages 2, 3a and 3b versus stage 1 were 0.93 (0.82–1.06), 1.28 (1.10–1.49) and 1.39 (1.13–1.72), respectively. Sitagliptin was not associated with cardiovascular outcomes for any eGFR stage (interaction P values all >0.44). Kidney function declined at the same rate in both treatment groups, with a marginally lower but constant eGFR difference (−1.3 ml/min/1.73m2) in those assigned to sitagliptin. Treatment differences in these eGFR values remained after adjustment for region, baseline eGFR, baseline HbA1c, time of assessment and within-study HbA1c levels.ConclusionsImpaired kidney function is associated with worse cardiovascular outcomes. Sitagliptin has no clinically significant impact on cardiovascular or CKD outcomes, irrespective of baseline eGFR.

Publication status:PublishedPeer Review status:Peer reviewedVersion:Accepted manuscriptDate of acceptance:2016-09-16 Funder: Merck Sharp & Dohme   Notes:© 2016 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at http://www.diabetesjournals.org/content/license.

Bibliographic Details

Publisher: American Diabetes Association

Publisher Website: http://www.diabetesjournals.org/

Journal: Diabetes Caresee more from them

Publication Website: http://care.diabetesjournals.org/

Issue Date: 2016-10Identifiers

Doi: https://doi.org/10.2337/dc16-1415

Issn: 1935-5548

Uuid: uuid:b4cc8e73-d090-47ef-bef6-32671899764b

Urn: uri:b4cc8e73-d090-47ef-bef6-32671899764b

Pubs-id: pubs:652836 Item Description

Type: journal-article;

Language: ENG

Version: Accepted manuscriptKeywords: JOURNAL ARTICLE

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Autor: Cornel, JH - - - Bakris, GL - - - Stevens, SR - - - Alvarsson, M - - - Bax, WA - - - Chuang, L-M - - - Engel, SS - - - Lopes, RD

Fuente: https://ora.ox.ac.uk/objects/uuid:b4cc8e73-d090-47ef-bef6-32671899764b



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