Effects of pentoxifylline on proteinuria and glucose control in patients with type 2 diabetes: A prospective randomized double-blind multicenter study

Seung Jin Han, Hae Jin Kim, Dae Jung Kim, Seung Soo Sheen, Choon Hee Chung, Chul Woo Ahn, Se Hwa Kim, Yong Wook Cho, Seok Won Park, Soo Kyung Kim, Chul Sik Kim, Kyung Wook Kim, Kwan Woo Lee

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background: Pentoxifylline is a methylxanthine derivative with significant anti-inflammatory, anti-fibrotic, and anti-proliferative properties. Studies have shown that pentoxifylline may have renoprotective effects in patients with diabetic nephropathy. However, most of these studies were limited by small sample sizes. Therefore, we investigated whether pentoxifylline could reduce proteinuria in patients with diabetic nephropathy and residual proteinuria who received an angiotensin-converting enzyme inhibitor (ACEI) or an angiotensin II receptor blocker (ARB). We also studied the effects of pentoxifylline on glycemic control, insulin resistance, and inflammatory parameters. Methods: This was a prospective, randomized double-blind, placebo-controlled, multi-center study. A total of 174 patients with type 2 diabetes and albuminuria (>30 mg/g of creatinine) who were taking the recommended dosage of ACEI or ARB for > 6 months and receiving conventional therapy for diabetes were randomly assigned to receive pentoxifylline (1200 mg, daily; n=87) or a placebo (n=87) for 6 months. The endpoints were the effects of pentoxifylline on proteinuria, renal function, glucose control, and inflammatory parameters. Results: The percentage changes in proteinuria from baseline in the pentoxifylline and placebo groups were a decrease of 23 % and 4 %, respectively (p=0.012). In addition, significant reductions in fasting plasma glucose, glycated hemoglobin, and insulin resistance according to the homeostasis model assessment were observed in the pentoxifylline group compared to those in the placebo group. However there was no significant difference in serum tumor necrosis factor (TNF)-α between the groups. Conclusions: Pentoxifylline therapy reduced proteinuria and improved glucose control and insulin resistance without significant change of serum TNF-α in patients with type 2 diabetic nephropathy. Therefore, pentoxifylline is a potential therapeutic alternative for treating diabetes and diabetic nephropathy. Trial registration: NCT01382303.

Original languageEnglish
Article number64
JournalDiabetology and Metabolic Syndrome
Volume7
Issue number1
DOIs
Publication statusPublished - 2015 Jul 19

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Pentoxifylline
Proteinuria
Double-Blind Method
Type 2 Diabetes Mellitus
Multicenter Studies
Glucose
Diabetic Nephropathies
Placebos
Insulin Resistance
Angiotensin Receptor Antagonists
Angiotensin-Converting Enzyme Inhibitors
Tumor Necrosis Factor-alpha
Albuminuria
Glycosylated Hemoglobin A
Serum
Sample Size
Fasting
Creatinine
Homeostasis
Anti-Inflammatory Agents

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

Cite this

Han, Seung Jin ; Kim, Hae Jin ; Kim, Dae Jung ; Sheen, Seung Soo ; Chung, Choon Hee ; Ahn, Chul Woo ; Kim, Se Hwa ; Cho, Yong Wook ; Park, Seok Won ; Kim, Soo Kyung ; Kim, Chul Sik ; Kim, Kyung Wook ; Lee, Kwan Woo. / Effects of pentoxifylline on proteinuria and glucose control in patients with type 2 diabetes : A prospective randomized double-blind multicenter study. In: Diabetology and Metabolic Syndrome. 2015 ; Vol. 7, No. 1.
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abstract = "Background: Pentoxifylline is a methylxanthine derivative with significant anti-inflammatory, anti-fibrotic, and anti-proliferative properties. Studies have shown that pentoxifylline may have renoprotective effects in patients with diabetic nephropathy. However, most of these studies were limited by small sample sizes. Therefore, we investigated whether pentoxifylline could reduce proteinuria in patients with diabetic nephropathy and residual proteinuria who received an angiotensin-converting enzyme inhibitor (ACEI) or an angiotensin II receptor blocker (ARB). We also studied the effects of pentoxifylline on glycemic control, insulin resistance, and inflammatory parameters. Methods: This was a prospective, randomized double-blind, placebo-controlled, multi-center study. A total of 174 patients with type 2 diabetes and albuminuria (>30 mg/g of creatinine) who were taking the recommended dosage of ACEI or ARB for > 6 months and receiving conventional therapy for diabetes were randomly assigned to receive pentoxifylline (1200 mg, daily; n=87) or a placebo (n=87) for 6 months. The endpoints were the effects of pentoxifylline on proteinuria, renal function, glucose control, and inflammatory parameters. Results: The percentage changes in proteinuria from baseline in the pentoxifylline and placebo groups were a decrease of 23 {\%} and 4 {\%}, respectively (p=0.012). In addition, significant reductions in fasting plasma glucose, glycated hemoglobin, and insulin resistance according to the homeostasis model assessment were observed in the pentoxifylline group compared to those in the placebo group. However there was no significant difference in serum tumor necrosis factor (TNF)-α between the groups. Conclusions: Pentoxifylline therapy reduced proteinuria and improved glucose control and insulin resistance without significant change of serum TNF-α in patients with type 2 diabetic nephropathy. Therefore, pentoxifylline is a potential therapeutic alternative for treating diabetes and diabetic nephropathy. Trial registration: NCT01382303.",
author = "Han, {Seung Jin} and Kim, {Hae Jin} and Kim, {Dae Jung} and Sheen, {Seung Soo} and Chung, {Choon Hee} and Ahn, {Chul Woo} and Kim, {Se Hwa} and Cho, {Yong Wook} and Park, {Seok Won} and Kim, {Soo Kyung} and Kim, {Chul Sik} and Kim, {Kyung Wook} and Lee, {Kwan Woo}",
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Effects of pentoxifylline on proteinuria and glucose control in patients with type 2 diabetes : A prospective randomized double-blind multicenter study. / Han, Seung Jin; Kim, Hae Jin; Kim, Dae Jung; Sheen, Seung Soo; Chung, Choon Hee; Ahn, Chul Woo; Kim, Se Hwa; Cho, Yong Wook; Park, Seok Won; Kim, Soo Kyung; Kim, Chul Sik; Kim, Kyung Wook; Lee, Kwan Woo.

In: Diabetology and Metabolic Syndrome, Vol. 7, No. 1, 64, 19.07.2015.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Effects of pentoxifylline on proteinuria and glucose control in patients with type 2 diabetes

T2 - A prospective randomized double-blind multicenter study

AU - Han, Seung Jin

AU - Kim, Hae Jin

AU - Kim, Dae Jung

AU - Sheen, Seung Soo

AU - Chung, Choon Hee

AU - Ahn, Chul Woo

AU - Kim, Se Hwa

AU - Cho, Yong Wook

AU - Park, Seok Won

AU - Kim, Soo Kyung

AU - Kim, Chul Sik

AU - Kim, Kyung Wook

AU - Lee, Kwan Woo

PY - 2015/7/19

Y1 - 2015/7/19

N2 - Background: Pentoxifylline is a methylxanthine derivative with significant anti-inflammatory, anti-fibrotic, and anti-proliferative properties. Studies have shown that pentoxifylline may have renoprotective effects in patients with diabetic nephropathy. However, most of these studies were limited by small sample sizes. Therefore, we investigated whether pentoxifylline could reduce proteinuria in patients with diabetic nephropathy and residual proteinuria who received an angiotensin-converting enzyme inhibitor (ACEI) or an angiotensin II receptor blocker (ARB). We also studied the effects of pentoxifylline on glycemic control, insulin resistance, and inflammatory parameters. Methods: This was a prospective, randomized double-blind, placebo-controlled, multi-center study. A total of 174 patients with type 2 diabetes and albuminuria (>30 mg/g of creatinine) who were taking the recommended dosage of ACEI or ARB for > 6 months and receiving conventional therapy for diabetes were randomly assigned to receive pentoxifylline (1200 mg, daily; n=87) or a placebo (n=87) for 6 months. The endpoints were the effects of pentoxifylline on proteinuria, renal function, glucose control, and inflammatory parameters. Results: The percentage changes in proteinuria from baseline in the pentoxifylline and placebo groups were a decrease of 23 % and 4 %, respectively (p=0.012). In addition, significant reductions in fasting plasma glucose, glycated hemoglobin, and insulin resistance according to the homeostasis model assessment were observed in the pentoxifylline group compared to those in the placebo group. However there was no significant difference in serum tumor necrosis factor (TNF)-α between the groups. Conclusions: Pentoxifylline therapy reduced proteinuria and improved glucose control and insulin resistance without significant change of serum TNF-α in patients with type 2 diabetic nephropathy. Therefore, pentoxifylline is a potential therapeutic alternative for treating diabetes and diabetic nephropathy. Trial registration: NCT01382303.

AB - Background: Pentoxifylline is a methylxanthine derivative with significant anti-inflammatory, anti-fibrotic, and anti-proliferative properties. Studies have shown that pentoxifylline may have renoprotective effects in patients with diabetic nephropathy. However, most of these studies were limited by small sample sizes. Therefore, we investigated whether pentoxifylline could reduce proteinuria in patients with diabetic nephropathy and residual proteinuria who received an angiotensin-converting enzyme inhibitor (ACEI) or an angiotensin II receptor blocker (ARB). We also studied the effects of pentoxifylline on glycemic control, insulin resistance, and inflammatory parameters. Methods: This was a prospective, randomized double-blind, placebo-controlled, multi-center study. A total of 174 patients with type 2 diabetes and albuminuria (>30 mg/g of creatinine) who were taking the recommended dosage of ACEI or ARB for > 6 months and receiving conventional therapy for diabetes were randomly assigned to receive pentoxifylline (1200 mg, daily; n=87) or a placebo (n=87) for 6 months. The endpoints were the effects of pentoxifylline on proteinuria, renal function, glucose control, and inflammatory parameters. Results: The percentage changes in proteinuria from baseline in the pentoxifylline and placebo groups were a decrease of 23 % and 4 %, respectively (p=0.012). In addition, significant reductions in fasting plasma glucose, glycated hemoglobin, and insulin resistance according to the homeostasis model assessment were observed in the pentoxifylline group compared to those in the placebo group. However there was no significant difference in serum tumor necrosis factor (TNF)-α between the groups. Conclusions: Pentoxifylline therapy reduced proteinuria and improved glucose control and insulin resistance without significant change of serum TNF-α in patients with type 2 diabetic nephropathy. Therefore, pentoxifylline is a potential therapeutic alternative for treating diabetes and diabetic nephropathy. Trial registration: NCT01382303.

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