Different effects of linagliptin and sitagliptin on blood pressure and renal function in Japanese patients with type 2 diabetes mellitus

Aims: To compare and evaluate effects of two DPP-4 inhibitors with different excretion routes on systemic and renal hemodynamics in Japanese patients with type 2 diabetes mellitus.

Methods: Seventy-three outpatients with type 2 diabetes who had been treated by 50 mg/day of sitagliptin (S) for at least 1 year were enrolled and prescribed 5 mg/day of linagliptin (L) instead of S for the next 1 year.

Results: After the initiation of S, the systolic and diastolic blood pressure decreased significantly. However, after switching to L for 1 year they increased significantly and returned to a comparable level as those before S treatment. The increase in serum creatinine or uric acid levels and the decrease in eGFR after S initiation were completely stopped or reversed after switching to L. The change in eGFR after the initiation of S was negatively correlated with the eGFR value at 1 year before switching.

Conclusions: The administration of S had an obvious effect on the systemic or renal hemodynamics in contrast to the fact that the administration of L had no effect on these parameters. It is thus important to use these agents with different excretion routes, properly taking the patients' renal function into account.