Rhinorrhea, cough and fatigue in patients taking sitagliptin 英文参考文献.docVIP

Baraniuk and Jamieson Allergy, Asthma Clinical Immunology 2010, 6:8 /content/6/1/8 ALLERGY, ASTHMA CLINICAL IMMUNOLOGY RESEARCH Open Access Rhinorrhea, cough and fatigue in patients taking Research sitagliptin James N Baraniuk1 and Mary J Jamieson*2 Abstract Sitagliptin is a dipeptidyl peptidase-4 (DPP IV, CD26) inhibitor indicated for treatment of Type II diabetes as a second line therapy after metformin. We report fifteen sitagliptin intolerant patients who developed anterior and posterior rhinorrhea, cough, dyspnea, and fatigue. Symptoms typically developed within 1 to 8 weeks of starting, and resolved within 1 week of stopping the drug. Peak expiratory flow rates increased 34% in 8 patients who stopped sitagliptin. Similar changes were found in 4 out of 5 persons who had confirmatory readministration. Chart review identified 17 patients who tolerated sitagliptin and had no symptomatic changes. The sitagliptin intolerant group had higher rates of clinically diagnosed allergic rhinitis (15/15 vs. 6/18; p = 0.00005), Fishers Exact test) and angiotensin converting enzyme inhibitor - induced cough (6/13 vs. 1/18; p = 0.012). Nasal and inhaled glucocorticoids may control the underlying allergic inflammation and abrogate this new sitagliptin - induced pharmacological syndrome. Potential mucosal and central nervous system mechanisms include disruption of neuropeptides and/or cytokines that rely on DPP IV for activation or inactivation, and T cell dysfunction. Background gliptin induced a reproducible syndrome. When the challenges were affirmative, we reviewed charts to iden- tify other sitagliptin - treated subjects. We identified sita- Sitagliptin is a selective dipeptidylpeptidase-4 (DPP IV, CD26, EC ) inhibitor indicated for the treatment of Type II diabetes mellitus [1]. Diabetics treated with gliptin intolerant and tolerant groups, and began an sitagliptin (Januvia?, Merck Co., Inc., Whitehouse Sta- tion, N.J.)