Publication details
Co přináší studie EXAMINE - alogliptin po akutním koronárním syndromu u pacientů s diabetem mellitem 2. typu
| Title in English | What the examine trial has shown: alogliptin after acute coronary syndrome in patients with type 1 diabetes mellitus |
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| Authors | |
| Year of publication | 2015 |
| Type | Article in Periodical |
| Magazine / Source | Intervenční a akutní kardiologie |
| MU Faculty or unit | |
| Citation | |
| Field | Cardiovascular diseases incl. cardiosurgery |
| Keywords | alogliptin; acute coronary syndrome; glycated haemoglobin; hypoglycaemia; pancreatitis |
| Description | Type 2 diabetes mellitus (T2DM) is a serious chronic condition with an increasing incidence in the developed countries. At present, novel drug classes are being introduced in the treatment of diabetes, for which most new data are available concerning the action on the incretin system. Incretin hormones currently include GLP-1 (glucagon-like peptide 1) and GIP (gastric inhibitory polypep-tide). Both these incretin hormones are metabolized within minutes by the enzyme dipeptidyl peptidase 4 (DPP-4). The mechanism of action of these drugs, called gliptins, consists in inhibiting DPP-4. The EXAMINE trial, in which alogliptin was administered following acute coronary syndrome in patients with T2DM, randomized 5,380 patients to receive alogliptin or placebo; the patients were followed up for up to 40 months (with a median duration of treatment with alogliptin of 18 months). The primary endpoint (death from cardiovascular causes, non-fatal myocardial infarction, and non-fatal stroke) occurred in 305 patients in the alogliptin group (11.3%) and in 316 patients in the placebo group (11.8%), p < 0.001 for non-inferiority. The level of glycated haemoglobin was significantly more reduced following the use of alogliptin, by 0.36%, p < 0.001. The rates of adverse effects, such as hypoglycaemia, pancreatitis, or the need for dialysis, were similar in both groups. While having similar cardiovascular morbidity and mortality, alogliptin in patients after acute coronary event and with T2DM was effective in reducing the level of glycated haemoglobin without having increased the rate or intensity of adverse effects. |