Pathophysiologically based treatment of type 2 diabetes mellitus with dipeptidyl peptidase 4 inhibitors

• Lilit V. Egshatyan

Abstract

Modern healthcare is constantly faced with the problem of acute infections outbreaks and the active growth of chronic non-communicable diseases such as type 2 diabetes mellitus (T2DM), kidney and cardiovascular pathology. The last diseases are multifactorial conditions with multiple etiologies that share similar pathophysiologies. Increased mortality due to T2DM has been associated with renal and/or cardiovascular dysfunction. The chronic complications of T2DM depend on the duration of hyperglycemia and are minimized with the use of novel anti-hyperglycemia drugs at the initial stages of the disease. According to clinical guidelines, if the effect of metformin is limited, it can be combined with a second- or third-line hypoglycemic drug. Multiple efficacy and safety studies suggest that dipeptidyl peptidase-4 inhibitors (iDPP4) have potential benefits in T2DM with chronic kidney disease and/or variety of cardiovascular diseases, including hypertension, calcific aortic valve disease, coronary atherosclerosis, and heart failure. This review summarized the recent data on the effectiveness and safety of iDPP4 use in cardiovascular and chronic kidney diseases in T2DM. The appearance of generic iDPP4 products that meet quality criteria and confidently occupy leading positions in the Russian pharmacy market is also discussed. The largest pharmaceutical manufacturer of generic is Gedeon Richter (Hungary) with the drugs Agartha® (Vildagliptin), Agartha®Met (Vildagliptin + Metformin) and Citadiab® (Sitagliptin).

Keywords: type 2 diabetes mellitus; cardiovascular disease; chronic kidney diseases; dipeptidyl peptidase 4 inhibitors; Agartha®; Agartha®Met; Citadiab®

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