Vol 7, No 5 (2018)
Research paper
Published online: 2018-11-27

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Efficacy and safety of substituting teneligliptin with hydroxychloroquine in inadequately controlled type 2 diabetes subjects with combination therapy of teneligliptin, metformin and glimepiride with or without other antidiabetic therapy: The TENE-HYQ SHIFT Study

U.P. Singh1, Arjun Baidya2, Manikant Singla3, Swapnil Jain4, Sharad Kumar5, Ravi Kant Sarogi6, Amit Gupta7, Rishad Ahmed8, Avhay Srivastav9, D.K. Chauhan10, Nishesh Jain11
Clin Diabetol 2018;7(5):209-214.

Abstract

Introduction. To confirm the efficacy and safety of substituting teneligliptin with hydroxychloroquine in inadequately control type 2 diabetes patients (T2DM) despite treatment with teneligliptin, metformin and glimepiride with or without other antidiabetic therapy. Material and methods. This is a multicentre observational, retrospective, 24 week clinical study performed in type 2 diabetes patients with HbA1c in the range of 7.5% to 9.5%. This patients were on teneligliptin 20 mg in addition of metformin and glimepiride with or without other antidiabetic therapy. Teneligliptin 20 mg treatment was replaced by hydroxychloroquine 400 mg. The primary endpoint was change in fasting blood glucose (FBG), postprandial blood glucose (PPBG) and HbA1c from baseline to week 24. The secondary outcome of the study was the proportion of patients who achieved good glycaemic control (HbA1c < 7%) and change in estimated glomerular filtration rate (eGFR), blood urea, serum creatinine and lipid profile levels by the end of the study. Data was taken from patients medical records of the Hospital and Private clinic. Results. Total of 500 patients’ data was analysed and after 24 week of follow up these patients presented with significant decrease in HbA1c (–1.1 ± 0.17%; p = 0.000); FBG (–29.87 ± 8.9 mg/dl), PPBG (–56.89 ± 9.2 mg/dl) with 52% of patients had achieved HbA1c levels < 7% at the end of the study which confirmed superiority of switching to hydroxychloroquine from teneligliptin. It has also been observed that after the switch from teneligliptin to hydroxychloroquine there was no change in serum creatinine and eGFR and further statistically significant change in total cholesterol, triglycerides and LDL levels with marginal increase in HDL level. Conclusions. In T2DM patients inadequately controlled on teneligliptin 20 mg along with combination of metformin and glimepiride with or without other antidiabetic therapy, substitute with hydroxychloroquine 400 mg may be a simple yet effective therapeutic option with clinical benefit beyond strict glycemic control without compromising patient’s safety.

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References

  1. Kahn SE. The relative contributions of insulin resistance and beta-cell dysfunction to the pathophysiology of Type 2 diabetes. Diabetologia. 2003; 46(1): 3–19.
  2. American Diabetes Association. 1. Promoting Health and Reducing Disparities in Populations. Diabetes Care. 2017; 40(Suppl 1): 6–10.
  3. Herman WH, Kalyani RR, Wexler DJ, et al. American Diabetes Association. Comment on American Diabetes Association. Approaches to Glycemic Treatment. Sec. 7. In Standards of Medical Care in Diabetes-2016. Diabetes Care 2016;39(Suppl. 1):S52-S59. Diabetes Care. 2016; 39(6): e86–e87.
  4. Kishimoto M. Teneligliptin: a DPP-4 inhibitor for the treatment of type 2 diabetes. Diabetes Metab Syndr Obes. 2013; 6: 187–195.
  5. Nabeno M, Akahoshi F, Kishida H, et al. A comparative study of the binding modes of recently launched dipeptidyl peptidase IV inhibitors in the active site. Biochem Biophys Res Commun. 2013; 434(2): 191–196.
  6. Eto T, Inoue S, Kadowaki T. Effects of once-daily teneligliptin on 24-h blood glucose control and safety in Japanese patients with type 2 diabetes mellitus: a 4-week, randomized, double-blind, placebo-controlled trial. Diabetes Obes Metab. 2012; 14(11): 1040–1046.
  7. Fessler BJ, Alarcón GS, McGwin G, et al. LUMINA Study Group. Systemic lupus erythematosus in three ethnic groups: XVI. Association of hydroxychloroquine use with reduced risk of damage accrual. Arthritis Rheum. 2005; 52(5): 1473–1480.
  8. Jagnani VK, Bhattacharya NR, Satpathy SC, et al. Effect of Hydroxychloroquine on Type 2 Diabetes Mellitus Unresponsive to More Than Two Oral Antidiabetic Agents. Journal of Diabetes & Metabolism. 2017; 8(10): 771.
  9. Surendra PS, et al. Surendra Prasad Singh, Comparative Study to Evaluate Effect of Hydroxychloroquine Versus Sitagliptin as Add on Therapy in Patients with Type 2 Diabetes Inadequately Controlled on Combination with Metformin and Gliclazide: A Multicentre, Observational Trial. Sch. J. App. Med. Sci. 2018; 6(5): 2150–2156.
  10. Baidya A, Kumar M, Pathak SK, et al. Study of comparative effect of hydroxychloroquine and vildagliptin on glycaemic efficacy and HbA1c in type 2 diabetes patients who were inadequately controlled with metformin and glimepiride dual therapy. JMSCR. 2018; 6(4): 409–415.
  11. Shashank J, Banshi S, et al. Hydroxychloroquine in type 2 diabetes with adhesive capsulitis. AACE 2017. ; Abstract #1110.
  12. Raheja BS, Kapur A, Bhoraskar A, et al. DiabCare Asia - India Study: diabetes care in India - current status. J Assoc Physicians India. 2001; 49: 717–722.
  13. Venugopal V, Selvaraj K, Majumdar A, et al. Opportunistic screening for diabetes mellitus among adults attending a primary health center in Puducherry. Int JMed Sci Public Health. 2015; 4(9): 1206–1211.
  14. Bajaj S. RSSDI clinical practice recommendations for the management of type 2 diabetes mellitus 2017. Int J Diabetes Dev Ctries. 2018; 38(Suppl 1): 1–115.
  15. Mohan V, Deepa R, Deepa M, et al. A simplified Indian Diabetes Risk Score for screening for undiagnosed diabetic subjects. J Assoc Physicians India. 2005; 53: 759–763.
  16. Pareek A, Chandurkar N, Thomas N, et al. Efficacy and safety of hydroxychloroquine in the treatment of type 2 diabetes mellitus: a double blind, randomized comparison with pioglitazone. Curr Med Res Opin. 2014; 30(7): 1257–1266.
  17. Yadav D, Mishra M, Tiwari A, et al. Prevalence of dyslipidemia and hypertension in Indian type 2 diabetic patients with metabolic syndrome and its clinical significance. Osong Public Health Res Perspect. 2014; 5(3): 169–175.
  18. Ghosh S, Trivedi S, Sanyal D, et al. Teneligliptin real-world efficacy assessment of type 2 diabetes mellitus patients in India (TREAT-INDIA study). Diabetes Metab Syndr Obes. 2016; 9: 347–353.