Exenatide, a drug commonly prescribed to help patients with type 2 diabetes improve blood sugar control, also has a powerful and rapid anti-inflammatory effect, a University at Buffalo study has shown.
The study of the drug, marketed under the trade name Byetta, was published recently in the Journal of Clinical Endocrinology and Metabolism.
"Our most important finding was this rapid, anti-inflammatory effect, which may lead to the inhibition of atherosclerosis, the major cause of heart attacks, strokes and gangrene in diabetics," says Paresh Dandona, MD, UB Distinguished Professor in the Department of Medicine, UB School of Medicine and Biomedical Sciences, and senior author.
It was especially noteworthy that this anti-inflammatory effect occurred independently of weight loss over the 12-week study period, he adds.
"The fact that the drug caused this dramatic and comprehensive anti-inflammatory effect independent of weight loss shows that it is a primary action of the drug and is not dependent upon weight loss," says Ajay Chaudhuri, MD, associate professor of medicine at UB and lead author.
He explains that, since obesity is an inflammatory state and adipose tissue contributes to inflammation, weight loss on its own can lead to an anti-inflammatory effect.
"Even more importantly, a short-lived anti-inflammatory effect was observed within two hours following a single injection of 5 micrograms of the drug," Chaudhuri continues. "This coincides with the peak concentration of the drug after the injection. Such a rapid and dramatic effect is rare."
"Apart from corticosteroids, which are known anti-inflammatory drugs, and insulin, no other drug demonstrates such a powerful and rapid anti-inflammatory effect," adds Dandona.
As a result, he and his colleagues at UB plan to study how exenatide might be used in acute inflammatory settings in the intensive care unit or following heart attacks and strokes, where a rapid anti-inflammatory effect is required and such drugs may be of potential use.
In addition to the anti-inflammatory effect, participants also exhibited a drop in the measurement of average blood sugar levels over three months, called hemoglobin A1C, from 8.6 percent to 7.4 percent.
The study involved 24 obese type 2 diabetics who were already on insulin to control their glucose levels.
The current study was undertaken based on previous observations published in 2007 by the UB researchers that exenatide indicated an anti-inflammatory effect, reducing plasma C-reactive protein levels, triglycerides and systolic blood pressure.
Co-authors with Chaudhuri and Dandona are Mehul Vora, MD, clinical assistant instructor of medicine; Husam Ghanim, PhD, research assistant professor of medicine; Sandeep Dhindsa, MD, and Antoine Makdissi, MD, both assistant professors of medicine; and Chang Ling Sia and Kelly Korzeniewski, research assistants in the UB Department of Medicine, all of the Division of Endocrinology, Diabetes and Metabolism of UB and Kaleida Health.
The study was supported by a grant from the Amylin Corporation and Eli-Lilly.
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