Publicado

2015-04-01

Inhibidores de dipeptidil dipeptidasa-IV: de la teoría a la práctica

Dipeptidil dipeptidase-IV inhibidors: from the theory to the practice

Palabras clave:

Diabetes mellitus tipo 2, Inhibidores de dipeptidil-peptidasa IV, Incretinas (es)
Diabetes mellitus type 2, Dipeptidyl-peptidase IV inhibitors, Incretins (en)

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Autores/as

  • Yessica Agudelo-Zapata Departamento de Medicina Interna, Facultad de Medicina. Universidad Nacional de Colombia. Bogotá, D.C.
  • Álvaro Javier Burgos-Cárdenas Departamento de Medicina Interna, Facultad de Medicina. Universidad Nacional de Colombia. Bogotá, D.C.
  • Ángela Johana Díaz-Martíez Departamento de Medicina Interna, Facultad de Medicina. Universidad Nacional de Colombia. Bogotá, D.C.
  • Análida Elizabeth Pinilla-Roa Departamento de Medicina Interna, Facultad de Medicina. Universidad Nacional de Colombia. Bogotá, D.C.

Esta revisión de los inhibidores de dipeptidil peptidasa-IV busca motivar el uso racional de tal grupo farmacológico en la práctica diaria. Este grupo es una nueva opción terapéutica en monoterapia o terapia combinada para el tratamiento de los pacientes con diabetes mellitus tipo 2. En Colombia, se encuentran disponibles: sitagliptina, vildagliptina, saxagliptina y linagliptina.

Si bien todas las gliptinas tienen el mismo mecanismo de acción—aumentan la vida media del péptido similar al glucagón—, esta revisión presenta las diferencias entre sus propiedades farmacológicas, eventos adversos y perfil de seguridad. Estos medicamentos son de segunda o tercera línea para el tratamiento oral de los pacientes con diabetes mellitus tipo 2, o primera línea en los pacientes intolerantes a la metformina. Además, algunas de las ventajas que tienen son que: generan menor riesgo de hipoglucemia, tienen efecto neutro sobre el peso, son seguros en adultos mayores, disminuyen la variabilidad de la glucemia y, adicionalmente, se pueden utilizar en la enfermedad renal crónica avanzada, con o sin terapia de reemplazo renal, y en la insuficiencia hepática.

This review of dipeptidyl peptidase-IV inhibitors seeks to encourage the rational use of these drugs in daily practice; this group is a new therapeutic option in monotherapy or combination therapy for the treatment of patients with diabetes mellitus type 2. Sitagliptin, vildagliptin, saxagliptin and linagliptin are available in Colombia.

While all gliptins have the same mechanism of action—they increase the average life of glucagon-like peptide—, this review presents the differences among their pharmacological properties, adverse events and safety profile. These drugs are second or third-line for the oral treatment of patients with diabetes mellitus type 2, or first-line in patients intolerant to metformin. They also have some advantages like lower risk of hypoglycemia, neutral effect on weight, safety for the elderly, reduction of glycaemia variability; additionally, they can be used in advanced chronic kidney disease, with or without renal replacement therapy, and in liver failure

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Citas

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