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The MARLINA-T2D trial: putting the results into clinical perspective

Rosemarie Lajara1

  • 1a Health Center at Plano , Plano , TX , USA.

Expert Review of Endocrinology & Metabolism
|July 31, 2018
PubMed

Insights

Dipeptidyl peptidase-4 (DPP-4) inhibitors like linagliptin show promise for managing type 2 diabetes mellitus (T2D) with chronic kidney disease (CKD). The MARLINA-T2D study found linagliptin improved glycemic control without adverse renal effects in T2D patients with early kidney disease.

Area of Science:

  • Nephrology
  • Endocrinology
  • Pharmacology

Background:

  • Type 2 diabetes mellitus (T2D) and chronic kidney disease (CKD) frequently co-occur, leading to adverse clinical outcomes.
  • Dipeptidyl peptidase-4 (DPP-4) inhibitors are used for T2D management and show preclinical potential for slowing kidney disease progression in T2D.
  • Clinical data on the renal effects of DPP-4 inhibitors remain limited.

Purpose of the Study:

  • To evaluate the renal effects of linagliptin, a DPP-4 inhibitor, in patients with T2D and early diabetic kidney disease.
  • To assess the impact of linagliptin on glycemic control and albuminuria in this high-risk population.

Main Methods:

  • The MARLINA-T2D study investigated linagliptin's effects in patients with T2D and early diabetic kidney disease.
  • Key outcome measures included glycemic control (HbA1c) and urinary albumin-to-creatinine ratio (UACR).

Main Results:

  • Linagliptin treatment resulted in significant improvements in glycemic control.
  • A non-significant reduction in albuminuria was observed.
  • No evidence of renal adverse effects was detected during the study period.

Conclusions:

  • Linagliptin effectively improves glycemic control in patients with T2D and early diabetic kidney disease.
  • While not conclusively demonstrating renoprotective effects in this study, linagliptin was well-tolerated with no renal adverse events.
  • Further research, including ongoing trials with primary renal endpoints, is needed to fully elucidate the long-term renal benefits of DPP-4 inhibitors.
Keywords:
Linagliptinalbuminuriadipeptidyl peptidase 4 inhibitorsrenal insufficiencytype 2 diabetes mellitus

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