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DPP-4 Inhibitor Shows Promise in Reducing Poor COVID-19 Outcomes

A common diabetes medication might help protect COVID-19 patients with type 2 diabetes from worse outcomes linked to that co-morbidity. Those receiving sitagliptin at the time of hospitalization instead of standard care had reduced mortality and an improvement in clinical outcomes. Here are more details.

PAVIA, ITALY – Type 2 diabetes is considered to be a co-morbidity that worsens outcomes in COVID-19. A new study suggests, however, that a common T2D treatment might more than reverse that effect.

The multicenter, case control, retrospective observational study was conducted in an effort to explore novel therapeutic options for T2D patients, according to a report in Diabetes Care.

Italian researchers from the University of Pavia note that poor outcomes have been reported in patients with type 2 diabetes and coronavirus disease 2019 (COVID-19). The focus was on sitagliptin, an oral and highly selective dipeptidyl peptidase 4 inhibitor, which was added to standard of care (e.g., insulin administration) at the time of hospitalization in patients with type 2 diabetes who were hospitalized with COVID-19.

Researchers note that every center also recruited at a 1:1 ratio untreated control subjects matched for age and sex. Participants all had pneumonia and exhibited oxygen saturation n <95% when breathing ambient air or when receiving oxygen support.

Defined as primary endpoints in the study were discharge from the hospital/death and improvement of clinical outcomes, i.e., an increase in at least two points on a seven-category modified ordinal scale. The study team collected data retrospectively from patients receiving sitagliptin from March 1 through April 30, 2020.

Of the 338 consecutive patients with type 2 diabetes and COVID-19 admitted in Northern Italy hospitals included in this study, 169 were on sitagliptin, while 169 were on standard of care.

Results indicate that treatment with sitagliptin at the time of hospitalization was associated with reduced mortality (18% vs. 37% of deceased patients; hazard ratio 0.44 [95% CI 0.29–0.66]; P 5 0.0001). Researchers also said the patients receiving the DPP-4 inhibitor had an improvement in clinical outcomes (60% vs. 38% of improved patients; P 5 0.0001) and a greater number of hospital discharges (120 vs. 89 of discharged patients; P 5 0.0008), compared with patients receiving standard of care, respectively.

“In this multicenter, case-control, retrospective, observational study of patients with type 2 diabetes admitted to the hospital for COVID-19, sitagliptin treatment at the time of hospitalization was associated with reduced mortality and improved clinical outcomes as compared with standard-of-care treatment,” the authors conclude. “The effects of sitagliptin in patients with type 2 diabetes and COVID-19 should be confirmed in an ongoing randomized, placebo-controlled trial.”