Table 2.

Published studies with DPP-4i use in KT

Study id	Study design, follow-up	Population	Intervention/s	Outcome
Lane et al. [36]	Case series, n = 15 Follow-up: 3 months	KT recipients with eGFR >30 mL/min/1.73 m2 and diagnosis of PTDM	All patients treated with sitagliptin	Reduction in HbA1c from 7.2 ± 0.1% to 6.7 ± 0.2% (P = 0.002) No patient discontinuation because of side effects No symptomatic hypoglycaemia
Sanyal et al. [37]	Case series, n = 21 Follow-up: 6 months	KT recipients with diagnosis of PTDM and stable renal function *Immunosuppression: prednisone 5 mg/day and standard dose of tacrolimus	All patients received linagliptin monotherapy (5 mg/day)	Decrease in FPG of 22.21 mg/dL and decrease in postprandial plasma glucose of 40.07 mg/dL (P < 0.01) Decrease of HbA1c 0.6% in 24 weeks
Soliman et al. [38]	RCT, n = 62 Follow-up: 3 months	KT recipients with PTDM receiving metformin and inadequate glycaemic control	Metformin + sitagliptin versus metformin + insulin * Rescue therapy: pioglitazone	Similar reduction in HbA1c in both groups (−0.6 ± 0.5% with sitagliptin and −0.6 ± 0.6% in insulin group) Small weight loss in sitagliptin group (−0.4 kg) and weight gain in insulin group (+0.8 kg); P < 0.05 No severe adverse events
Boerner et al. [39]	Case series, n = 22 Mean follow-up: 32.5 ± 17.8 months	KT recipients with diagnosis of PTDM treated with sitagliptin alone	All patients treated with sitagliptin monotherapy	Mean HbA1c 6.5 ± 0.5%. No episodes of pancreatitis Rare transplant-specific adverse events
Haidinger et al. [40]	Phase II RCT, n = 33 Follow-up: 4 months	KT recipients (>6 months post-KT) with stable renal function and diagnosis of PTDM	Vildagliptin 50 mg/day versus placebo during 3 months	Reduced HbA1c (6.1% versus 6.5%, P < 0.05) and 2HPG (182.7 versus 231.2 mg/dL, P < 0.05) in the vildagliptin group versus placebo Mild adverse events, similar rates in both groups
Strøm Halden et al. [41]	RCT cross-over, n = 19 Follow-up: 8 weeks	KT recipients (>1a) with PTDM and stable renal function	4 weeks with sitagliptin followed by 4 weeks with no sitagliptin, versus vice versa * Also includes patients with other oral antidiabetic treatment, maintained with same dose	Significant increase of insulin secretion with sitagliptin Decrease in FPG [0.9 (0.5–1.7) mmol/L; P = 0.003] and 2HPG [2.9 (0.5–6.4) mmol/L; P = 0.004]
Guardado-Mendoza et al. [42]	Prospective cohort study, n = 28 Follow-up: 12 months	KT recipients with fasting hyperglicaemia during the first 24 h post-surgery	Linagliptin 5 mg/days plus insulin versus insulin alone	Lower glucose levels (131.0 ± 15.1 versus 191.1 ± 22.5 mg/dL) and insulin doses (37.5 ± 6.3 versus 24.2 ± 6.6 U) in the linagliptin + insulin group (P < 0.05) Less severe hypoglicaemia in linagliptin + insulin group (65.1 ± 2.2 versus 54.2 ± 3.3 mg/dL; P = 0.036)

FPG, fasting plasma glucose.