Vildagliptina en pacientes diabéticos tipo 2 con riesgo cardiovascular o compromiso renal. Revisión de literatura

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Autores

Víctor Hugo Forero
Gabriel German Ribón Quintero
Jairo Echeverry-Raad

Resumen

Introducción: los fármacos que se prescriben comúnmente para el tratamiento de la diabetes mellitus tipo 2 (DM2) tienen restricciones de uso en pacientes con deterioro cardiovascular o renal. Estudios publicados sobre el grupo farmacológico inhibidores de dipeptidil peptidasa-4 (DPP-4I) indican que se trata de agentes efectivos y seguros para su uso en esta población de pacientes. Sin embargo, en la práctica clínica cotidiana, prevalecen vacíos e incertidumbre respecto de la efectividad y seguridad para prescribir apropiadamente los DPP-4I, específicamente en pacientes en quienes concurre el riesgo o presencia de enfermedad cardiovascular o renal.

Esta revisión de literatura integra estudios publicados entre 2015 -2018,  en seguridad, eficacia y uso de vildagliptina en para pacientes con DM2 en riesgo incrementado de eventos o presencia de enfermedad cardiovascular, función renal comprometida, o ambos.

Método: revisión de literatura publicada desde 01-01- 2015 a 31-05- 2018, enfocada en  seguridad, eficacia y uso de vildagliptina en pacientes adultos con DM2 en riesgo de evento o presencia de enfermedad cardiovascular o con compromiso de la función renal, o ambos.

Resultados: conjunto de evidencias de tres estudios de vida, seis ECCA, dos meta-análisis en red, nueve revisiones sistemáticas y tres estudios observacionales integran la unidad de análisis que presenta en síntesis narrativa desenlaces de efectividad y seguridad del DPP-4I vildagliptina en el contexto de pacientes diabéticos con  riesgo cardiovascular y  compromiso de función renal.

Conclusión: esta revisión reitera la trascendencia de intervenciones integrales, efectivas y seguras, para el control metabólico en personas con DBT, específicamente para pacientes en quienes concurre enfermedad cardiovascular, deterioro de función renal, y esquemas combinados con hipoglucemiante oral. En este contexto vildagliptina reúne valiosa evidencia de efectividad y seguridad que permite apoyar decisiones clínicas sustentadas. A destacar los beneficios para pacientes de edad avanzada, grupo especialmente frágil y vulnerable a eventos cardiovasculares.

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Derechos de autor 2018 Víctor Hugo Forero

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