Long-Term Effects of Ipragliflozin on Diabetic Nephropathy and Blood Pressure in Patients With Type 2 Diabetes: 104-Week Follow-up of an Open-Label Study
| Autor: | Daisuke Ito, Mitsuhiko Noda, Akira Shimada, Kazuyuki Inoue, Keiko Hamaguchi, Ikuo Inoue, Morifumi Yanagisawa, Kimie Kaneko, Kouichi Inukai, Takashi Sumita |
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| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Urinary system Urology Renal function 030209 endocrinology & metabolism Type 2 diabetes Diabetic nephropathy 030204 cardiovascular system & hematology Sodium-glucose cotransporter 2 inhibitor 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Long-term Diabetes mellitus medicine Glycemic business.industry General Medicine medicine.disease Ipragliflozin Blood pressure chemistry Original Article business |
| Zdroj: | Journal of Clinical Medicine Research |
| ISSN: | 1918-3003 |
| Popis: | Background: In our previous study, we investigated the efficacy of ipragliflozin, a sodium-glucose cotransporter (SGLT) 2 inhibitor on diabetic nephropathy in patients with type 2 diabetes and demonstrated that ipragliflozin significantly improved diabetic nephropathy in addition to reducing HbA1c and body weight. Herein, we conducted post-trial monitoring to determine whether these lowering effects on blood glucose and body weight or the beneficial effects on diabetic nephropathy were maintained long-term (104 weeks) after starting ipragliflozin treatment. Methods: Initially, during a 24-week interventional trial period, a 50 mg dose of ipragliflozin was administered to 50 patients with type 2 diabetes without changing other treatments. During the post-trial monitoring period, these patients returned to hospital-based diabetes care according to their clinical needs. We continued monitoring their clinical data for 104 weeks in each hospital and analyzed the results on an intention-to-treat basis. Results: The improvements in glycemic control and body weight reduction provided by 24-week ipragliflozin administration were maintained for 104 weeks. Despite a transient decrease during the intervention period, the estimated glomerular filtration rate (eGFR) was restored to near the baseline level at 104 weeks. Notably, in patients with diabetic nephropathy, the median urinary albumin-to-creatinine ratio (UACR) was significantly decreased from 119.2 (98.9 - 201.8) at baseline to 36.9 (19.7 - 204.7) mg/gCr at 104 weeks. In addition, eGFR was stable for 104 weeks, showing no decrease. In contrast, a significant positive correlation between UACR and blood pressure observed at 24 weeks disappeared after discontinuation of the intervention therapy. Conclusions: The well-controlled HbA1c and body weight reductions were maintained for 104 weeks of post-trial follow-up. Moreover, ipragliflozin significantly reduced urinary albumin excretion in patients with diabetic nephropathy without decreasing eGFR. J Clin Med Res. 2018;10(9):679-687 doi: https://doi.org/10.14740/jocmr3491w |
| Databáze: | OpenAIRE |
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