Anti-inflammatory properties of antidiabetic drugs: A "promised land" in the COVID-19 era?

J Diabetes Complications. 2020 Dec;34(12):107723. doi: 10.1016/j.jdiacomp.2020.107723. Epub 2020 Aug 26.

Abstract

Inflammation is implicated in the development and severity of the coronavirus disease 2019 (COVID-19), as well as in the pathophysiology of diabetes. Diabetes, especially when uncontrolled, is also recognized as an important risk factor for COVID-19 morbidity and mortality. Furthermore, certain inflammatory markers [i.e. C-reactive protein (CRP), interleukin-6 (IL-6) and ferritin] were reported as strong predictors of worse outcomes in COVID-19 positive patients. The same biomarkers have been associated with poor glycemic control. Therefore, achieving euglycemia in patients with diabetes is even more important in the era of the COVID-19 pandemic. Based on the above, it is clinically interesting to elucidate whether antidiabetic drugs may reduce inflammation, thus possibly minimizing the risk for COVID-19 development and severity. The present narrative review discusses the potential anti-inflammatory properties of certain antidiabetic drugs (i.e. metformin, pioglitazone, sitagliptin, linagliptin, vildagliptin, alogliptin, saxagliptin, liraglutide, dulaglutide, exenatide, lixisenatide, semaglutide, empagliflozin, dapagliflozin, canagliflozin), with a focus on CRP, IL-6 and ferritin.

Keywords: C-reactive protein; Dipeptidyl peptidase 4 inhibitors; Ferritin; Glucagon-like peptide-1 receptor agonists; Interleukin 6; Metformin; Pioglitazone; Sodium-glucose co-transporter-2 inhibitors.

Publication types

  • Review

MeSH terms

  • Anti-Inflammatory Agents
  • COVID-19 / epidemiology*
  • COVID-19 / physiopathology
  • COVID-19 / prevention & control
  • Comorbidity
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Diabetes Mellitus, Type 2 / physiopathology
  • Dipeptidyl-Peptidase IV Inhibitors / therapeutic use
  • Glucagon-Like Peptide-1 Receptor / agonists
  • Humans
  • Hypoglycemic Agents / therapeutic use*
  • Inflammation / prevention & control*
  • Metformin / therapeutic use
  • Pioglitazone / therapeutic use
  • Risk Factors
  • SARS-CoV-2*
  • Sitagliptin Phosphate / therapeutic use
  • Sodium-Glucose Transporter 2 Inhibitors / therapeutic use

Substances

  • Anti-Inflammatory Agents
  • Dipeptidyl-Peptidase IV Inhibitors
  • Glucagon-Like Peptide-1 Receptor
  • Hypoglycemic Agents
  • Sodium-Glucose Transporter 2 Inhibitors
  • Metformin
  • Sitagliptin Phosphate
  • Pioglitazone