Lowering of blood pressure and pulse rate by switching from DPP-4 inhibitor to luseogliflozin in patients with type 2 diabetes complicated with hypertension: A multicenter, prospective, randomized, open-label, parallel-group comparison trial (LUNA study).

Abstract

AIMS:

Sodium-glucose cotransporter-2 inhibitor (SGLT2i) reduces clinic blood pressure (BP), but the effects on BP circadian rhythm remain unclear. The present study aimed to determine the nighttime antihypertensive effect of SGLT2i compared with dipeptidyl peptidase-4 inhibitor (DPP-4i) in patients with type 2 diabetes and hypertension.

MATERIALS AND METHODS:

In this randomized, open-label, parallel-group trial, patients treated with DPP-4i were either switched to luseogliflozin 2.5 mg/day (Luseo group;n = 30) or continued DPP-4i (DPP-4i group;n = 26). The patients undertook 24-h ambulatory BP monitoring before and 8 weeks after the group allocation. The primary endpoint was mean change in nighttime systolic BP (SBP).

RESULTS:

Nighttime SBP, as well as daytime SBP, was significantly reduced in the Luseo group compared with the DPP-4i group (nighttime, -4.0 ± 11.4 vs. 3.6 ± 10.7 mmHg,P = 0.01; daytime, -4.4 ± 10.9 vs. 3.7 ± 11.9 mmHg,P = 0.01). Similarly, nighttimepulse rate(PR) was significantly reduced in the Luseo group (-2.0 ± 4.8 vs. 0.9 ± 4.8 bpm,P = 0.03). The proportion of patients with abnormal BP circadian rhythms (non-dipper pattern plus riser pattern) was significantly lower in the Luseo group (36.6% vs. 56.7%,P < 0.05).

CONCLUSIONS:

Switching from DPP-4i to luseogliflozin decreased nighttime SBP and PR; moreover, BP circadian rhythm was improved.

• Authors: Reina Hashimoto-Kameda, Kyu Yong Cho, Hiroshi Nomoto, Akinobu Nakamura, Kazuno Omori, So Nagai, Sachiko Edagawa, Shinichiro Kawata, Jun Takeuchi, Hiraku Kameda, Yoshio Kurihara, Shin Aoki, Tatsuya Atsumi, Hideaki Miyoshi, LUNA Study Investigators
• Journal: Diabetes research and clinical practice (Diabetes Res Clin Pract) Vol. 180 Pg. 109069 (Oct 2021) ISSN: 1872-8227 [Electronic] Ireland
• PMID: 34563585 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial)
• Copyright: Copyright © 2021 The Author(s). Published by Elsevier B.V. All rights reserved.

Chemical References

• Dipeptidyl-Peptidase IV Inhibitors
• Sodium-Glucose Transporter 2 Inhibitors
• Sorbitol
• 1,5-anhydro-1-(5-(4-ethoxybenzyl)-2-methoxy-4-methylphenyl)-1-thioglucitol

Topics

• Blood Pressure
• Blood Pressure Monitoring, Ambulatory
• Circadian Rhythm
• Diabetes Mellitus, Type 2 (complications, drug therapy)
• Dipeptidyl-Peptidase IV Inhibitors
• Heart Rate
• Humans
• Hypertension (complications, drug therapy)
• Prospective Studies
• Sodium-Glucose Transporter 2 Inhibitors
• Sorbitol (analogs & derivatives)