title: Effects of pentoxifylline on proteinuria and glucose control in patients with type 2 diabetes: a prospective randomized double-blind multicenter study.
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.
  
  
  BACKGROUND
  NCT01382303.
authors: Department of Endocrinology and Metabolism, Ajou University School of Medicine, 164, World Cup-ro, Yeongtong-gu, Suwon, 443-380 Korea.
authors: Seung Jin
authors: SJ
authors: Han
authors: Department of Endocrinology and Metabolism, Ajou University School of Medicine, 164, World Cup-ro, Yeongtong-gu, Suwon, 443-380 Korea.
authors: Hae Jin
authors: HJ
authors: Kim
authors: Department of Endocrinology and Metabolism, Ajou University School of Medicine, 164, World Cup-ro, Yeongtong-gu, Suwon, 443-380 Korea.
authors: Dae Jung
authors: DJ
authors: Kim
authors: Section of Clinical Epidemiology and Biostatistics in Clinical Trial Center, Ajou University School of Medicine, Suwon, 443-380 Korea.
authors: Seung Soo
authors: SS
authors: Sheen
authors: Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, 220-701 Korea.
authors: Choon Hee
authors: CH
authors: Chung
authors: Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, 135-720 Korea.
authors: Chul Woo
authors: CW
authors: Ahn
authors: Division of Endocrinology, Department of Internal Medicine, Catholic Kwandong University College of Medicine, Incheon, 404-834 Korea.
authors: Se Hwa
authors: SH
authors: Kim
authors: Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, 463-712 Korea.
authors: Yong-Wook
authors: YW
authors: Cho
authors: Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, 463-712 Korea.
authors: Seok Won
authors: SW
authors: Park
authors: Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, 463-712 Korea.
authors: Soo-Kyung
authors: SK
authors: Kim
authors: Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, 431-796 Korea.
authors: Chul Sik
authors: CS
authors: Kim
authors: Dongtan jeil Women's Hospital, Hwaseong, 445-170 Korea ; Severance Institute for Vascular and Metabolic Research, Yonesei University College of Medicine, Seoul, 120-752 Korea.
authors: Kyung Wook
authors: KW
authors: Kim
authors: Department of Endocrinology and Metabolism, Ajou University School of Medicine, 164, World Cup-ro, Yeongtong-gu, Suwon, 443-380 Korea.
authors: Kwan Woo
authors: KW
authors: Lee
keywords: Diabetes mellitus; Diabetic nephropathy; Insulin resistance; Pentoxifylline; Proteinuria