4.6 Article

Antidiabetic Effects of the Senolytic Agent Dasatinib

Journal

MAYO CLINIC PROCEEDINGS
Volume 96, Issue 12, Pages 3021-3029

Publisher

ELSEVIER SCIENCE INC
DOI: 10.1016/j.mayocp.2021.06.025

Keywords

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Funding

  1. National Center for Advancing Translational Sciences [UL1 TR002377]
  2. Robert and Arlene Kogod Professorship in Geriatric Medicine
  3. National Institute on Aging [R37 AG13925]
  4. Noaber Foundation Professorship in Aging
  5. Connor Group
  6. Robert J. and Theresa W. Ryan Foundation
  7. Travelers Chair in Geriatrics and Gerontology

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The study shows that older patients with type 2 diabetes mellitus treated with dasatinib had significant improvements in antidiabetic outcomes compared to those treated with imatinib, including reductions in serum glucose concentration, total daily insulin units, and relative weight loss. This suggests that dasatinib may be a promising novel therapy for diabetes management.
Objective: To evaluate the antidiabetic effects of the senolytic agent dasatinib in older patients with type 2 diabetes mellitus. Methods: This retrospective cohort study included enterprise-wide Mayo Clinic patients using Informatics for Integrating Biology at the Bedside from January 1994 through December 2019. The antidiabetic outcomes (change in hemoglobin A(1c) value, serum glucose concentration, and diabetic medications) after 1 year of a strongly senolytic tyrosine kinase inhibitor, dasatinib (n=16), was compared with a weakly senolytic tyrosine kinase inhibitor, imatinib (n=32). Results: Relative to imatinib, patients treated with dasatinib had a mean reduction of 43.7 mg/dL (P=.005) in serum glucose concentration (to convert glucose values to mmol/L, multiply by 0.0555) and required 28.8 fewer total daily insulin units (P=.08) in the setting of a 4.8-kg relative weight loss (5.3% of total body weight; P=.045). Linear regression analysis suggests that the relative difference in weight accounts for 8.4 mg/dL of the 43.7 mg/dL blood glucose value decrease, or 19.2%. Relative to imatinib, patients treated with dasatinib had a mean 0.80 absolute point (P=.05) reduction in hemoglobin A(1c) and required 18.2 fewer total daily insulin units (P=.16) in the setting of a 5.9-kg relative weight loss (6.3% of total body weight; P=.06). Conclusion: Dasatinib may have antidiabetic effects comparable to contemporary diabetic treatments and may be considered for use as a novel diabetic therapy. Future studies are needed to determine whether these results are translatable to patients with type 2 diabetes mellitus without underlying malignant diseases and to determine whether the antidiabetic effects of dasatinib are due to its senolytic properties. (C) 2021 Mayo Foundation for Medical Education and Research

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