Di-peptidyl peptidase IV inhibitors: a New Horizon in Management of Atherosclerosis: a review

Background/Aims: Dipeptidyl peptidase-IV (DPP-4) inhibitors are relatively new class of anti-diabetic drugs that have therapeutic potential for management of atherosclerosis. Of the numerous DPP4-inhibitors in clinical practice no studies have been conducted to compare their anti-atherosclerotic effects despite growing evidence of their usefulness in the high risk population. The aim of the study was to evaluate and grade the anti-atherothrombotic effects of DPP-4 inhibitors in subjects with atherosclerosis. Method: A literature search was conducted on MEDLINE and the COCHRANE Library using the terms "DPP-4 Inhibitors", "atherosclerosis", "GLP", "inflammation", "cytokines", "stroke", "ischaemic heart disease", "hypertension", "peripheral vascular disease". A mathematical model devised by us was used to derive and compare the anti-inflammatory effects of the DPP-4 inhibitors using protective score [PS]. Data was analysed for Alogliptin, Linagliptin, Saxagliptin, Sitagliptin, and Vildagliptin. Results: Sixty two published studies collected in the search were assessed for relevance to this study. Sitagliptin had the highest PS [n=5] while Linagliptin and Saxagliptin yielded the lowest PS [n=1]. This comparison and scoring system was limited to the data collected; which did not investigate for all athero-thrombotic factors selected in this study. Conclusion: The findings reflected superiority of Sitagliptin over the other DPP-4 inhibitors in the management of atherosclerosis. Further investigations are required to establish specific inflammatory cytokines influenced by the DPP-4 inhibitors and to elucidate their clinical application in atherothrombotic disease.

Annals of the Australasian College of Tropical Medicine Inc

Annals of the Australasian College of Tropical Medicine

15

1448-4706

N/A

3

1