In patients with HIV, a diabetes drug may have benefits beyond lowering blood sugar. A new study from researchers at Washington University School of Medicine in St. Louis suggests the drug may prevent cardiovascular problems because it works to reduce inflammation linked to heart disease and stroke in these patients.
In the new study, the researchers found that the diabetes drug sitagliptin (brand name Januvia) both improved metabolism and reduced inflammation in HIV-positive adults taking antiretroviral therapy. The findings are published in The Journal of Clinical Endocrinology & Metabolism.
“The goal has been to identify treatments that not only address problems with blood sugar and lipids but also can lower inflammation, which can play a substantial role in heart disease and stroke,” said principal investigator Kevin E. Yarasheski, PhD, a professor of medicine. “With sitagliptin, sugar levels fell, and several markers of immune activation and inflammation were reduced, indicating the drug may provide long-term benefits for these patients’ hearts, bones and livers.”
“We wanted to know whether this drug would improve patients’ blood-sugar problems and reduce the immune markers that we believe are indicators that something is activating the immune system and causing inflammation,” Yarasheski said. “And that’s what we found.”
Longer-term studies are needed to learn whether lower markers of inflammation after eight weeks of treatment can lead to lower risk for heart attacks and metabolic problems, but the preliminary signs are promising, said Yarasheski, also a professor of cell biology and physiology and of physical therapy.
“Lowering blood sugar isn’t enough,” he said. “Just treating lipids isn’t enough. We want to target the nexus between metabolic regulation and immune regulation. Whether this particular drug lowers inflammation enough to actually reduce cardiovascular disease, heart attack, stroke and hypertension is a question that still needs to be addressed. But these findings are a step in the right direction.”
The featured article was originally published at Washington University’s Newsroom: Diabetes drug may reduce heart attack risk in HIV patients
This research was supported by Merck Pharmaceuticals and by the NIGMS, NIAID, NIDDK and the NCATS of the National Institutes of Health (NIH), grant numbers P41 GM103422, UM1 AI069495, P30 DK020579, P30 DK056341, T32 DK007120, NCATS UL1 TR000448.
Best C, Struthers H, Laciny E, Royal M, Reeds DN, Yarasheski KE. Sitagliptin reduces inflammation and chronic immune cell activation in HIV+ adults with impaired glucose tolerance. The Journal of Clinical Endocrinology & Metabolism, published online May 4, 2015; http://dx.doi.org/10.1210/jc.2015-1531