Effect of Vildagliptin on Endothelial Function in Patients with Type 2 Diabetes Mellitus and Hypertension

Presentation Number: SUN 623
Date of Presentation: April 2nd, 2017

Luciana Neves Cosenso-Martin*, Luiz Tadeu Giollo-Jr, Marcelo Nakazone and Jose Fernando Vilela-Martin Sr.
State Medical School at Sao Jose do Rio Preto (FAMERP)/Brazil, Sao Jose do Rio Preto, Brazil

Abstract

Introduction: Several trials have shown that dipeptidyl peptidase-4 (DPP-4) inhibitors, used to treat type 2 diabetes (T2DM), improve endothelial function. Hypothesis: The current study investigated the effects of vildagliptin, a DPP-4 inhibitor, compared to glibenclamide on endothelial function and arterial stiffness (AS) in patients with T2DM and hypertension (HT). Overview of experimental design and methodology: This trial was a prospective randomized, open label study, controlled by drug. Fifty over 35-year-old patients with T2DM and HT, without cardiovascular disease, were randomly allocated to treatment with vildagliptin (n=25) or glibenclamide (n=25). Both groups used metformin. Blood samples were drawn after fasting to measure glycemia and glycated hemoglobin (HbA1c) before and 12 weeks after treatment. Assessment of endothelial function was performed before and after 12 weeks of treatment. Endothelial function was evaluated by peripheral artery tonometry (endo-PAT2000), measuring the reactive hyperemia index (RHI). Aortic stiffness was also evaluated by augmentation index (AIx75) using the endo-PAT2000. The primary outcome of the study was change in the RHI after vildagliptin vs. glibenclamide treatment. Major results: HbA1c was similar in both groups at baseline and after 12 weeks of treatment it decreased, but not significantly (before 8.3% ± 1.0 and after treatment 8.0% ±1.34, P = 0.1814 in the vildagliptin group; 7.9% ± 0.9 and 7.5% ± 1.4, P = 0.1709 in the glibenclamide group). However, fasting glucose decreased significantly in both groups (166 ± 38.7 mg/dL vs 147.5 ± 42.6 mg/dL, P = 0.0185 in the vildagliptin group; 164 ± 43.5 mg/dL vs. 139 ± 54 mg/dL, P = 0.0170 in the glibenclamide group), but without difference between groups (P = 0.5676). There were no changes in RHI in the vildagliptin group (before 2.348 ± 0.5868; after treatment 2.2408 ± 0.6019, P = 0.742) or in the glibenclamide group (before 2.3636 ± 0.5163; after treatment 2.3375 ± 0.4996, P = 0.950) and no difference between groups (P = 0.5479). There was also no difference between vildagliptin and glibenclamide treatment in AIx75 (P = 0.696). Interpretation of results and conclusions: Vildagliptin in patients with T2DM and hypertension did not change the endothelial function and the aortic stiffness evaluated by tonometry during 12 weeks of treatment. Thus, this drug had a neutral effect on vascular function.

 

Disclosure: LNC: Investigator, Novartis Pharmaceuticals. JFV Sr.: Researcher, Novartis Pharmaceuticals. Nothing to Disclose: LTG, MN