Inhibitors Versus Diabetes … And Dementia!

Recent research by Seoul National University Bundang Hospital scientists in South Korea suggest that diabetes patients treated with sodium-glucose cotransporter-2 (SGLT-2) inhibitors or dipeptidyl peptidase-4 (DPP-4) inhibitors have a decreased risk of developing dementia.

Published in the BMJ and including research from the Lancet Commission report, the analysis also suggests that a lengthier use of the drugs decreased dementia risk further. A population-based cohort study of people with type 2 diabetes (aged between 40 and 69 years), Bundang researchers concluded that initiation of SGLT-2 inhibitors was associated with a 35 percent lower risk of dementia compared with initiation of DPP-4 inhibitors. A similar and consistent observation was also made in those with Alzheimer’s disease and vascular dementia. Furthermore, this result was observed to be greater in association with treatment duration exceeding two years. With the team now looking into future randomized controlled trials – and with the development of effective drugs for cognitive disorders still in the early stages – the demand for alternative treatment pathways has triggered a search for new, promising avenues.

Experts remain cautious about the findings, but look forward to confirmatory clinical trials. Jacqui Hanley, Head of Research at Alzheimer’s Research UK, said: “Using drugs that have already been shown to be safe for use in people could potentially speed up the process of testing them in clinical trials against dementia, as well as making it significantly cheaper. If we are to cure dementia, clinicians will need a toolkit of treatments which tackle different aspects of the disease and that can be used in combination. Research into repurposing drugs may help us do just that.”

University of Oxford Senior Clinical Researcher, Dementia Platform UK, Ivan Koychev added: “The results add to existing strong epidemiological evidence for dementia risk reduction through diabetes medications … They strengthen the case for testing in clinical trial settings these types of drugs in people at risk for dementia. The great advantage of this so-called repurposing approach (i.e. using an existing drug in a new indication) is that it reduces greatly the risk of the drug failing through safety concerns as they are already used in everyday clinical practice.”

It would appear that in the search for improved diabetes treatments, the industry is developing a versatile toolkit and ample resources to make an impact in other areas of vital medical need. Novo Nordisk’s Victoza (liraglutide), for example, has also shown the potential to slow the progress of Alzheimer’s disease.