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Colegio de Medicina Interna de México.

2015, Número 4

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Med Int Mex 2015; 31 (4)


Comparación de la eficacia de los iDPP-4 actualmente disponibles y ventajas antihiperglucemiantes de linagliptina en pacientes con diabetes mellitus 2

Zúñiga-Guajardo S, Rodríguez-Gutiérrez R, Yamamoto-Cuevas J, Juárez-Comboni SC

Idioma: Español
Referencias bibliográficas: 51
Paginas: 441-453
Archivo PDF: 627.88 Kb.


RESUMEN

La diabetes mellitus tipo 2 es una enfermedad en cuya etiopatogenia intervienen múltiples defectos, hecho que ha dado lugar a que continúen investigándose sustancias que sean capaces de corregir estos defectos y mejorar el control de la glucemia. A medida que transcurre el tiempo, la cronicidad de la diabetes mellitus tipo 2 se acompaña de la declinación progresiva en la función de la célula b y de la alteración del control de las células α en los islotes pancreáticos; en consecuencia, los fármacos convencionalmente prescritos para el tratamiento de los pacientes diabéticos pierden eficacia y exhiben gradualmente un amplio número de limitaciones, incluidos el aumento en el riesgo de episodios de hipoglucemia, efectos cada vez más prominentes en la ganancia de peso corporal y la inducción de eventos adversos de tipo gastrointestinal, edema e incluso insuficiencia cardiaca. El desarrollo de nuevos fármacos, entre los que se encuentran los inhibidores de la enzima dipeptidilpeptidasa tipo 4 (DPP-4), ha revolucionado durante la década actual el tratamiento de la diabetes mellitus tipo 2, debido a que estos agentes son eficaces para disminuir la glucosa, de manera que es improbable que produzcan hipoglucemia y, en modelos animales, se ha demostrado que pueden evitar la declinación progresiva en la función de la célula b y preservar la capacidad secretora de insulina. Además, no elevan el riesgo de hipoglucemia o de incremento del peso corporal. Estas características hacen de los inhibidores de la DPP-4 agentes idóneos para el tratamiento a largo plazo de los pacientes con diabetes mellitus tipo 2. En este artículo se analiza la eficacia para el control de la glucemia de estos nuevos agentes, ya sea en monoterapia o en distintas combinaciones terapéuticas. Asimismo, se evalúan la eficacia, la seguridad y la tolerabilidad del inhibidor de la DPP-4 linagliptina, administrado en monoterapia o combinado con metformina, insulina, glitazonas o sulfonilureas.


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