Diabetes drug could save mothers from miscarriage

Rahab Wangari suffered three miscarriages over 10 years.

The pain of the miscarriage and the longing to become a mother that always ended in heartache, choked her hopes. “I first conceived in 2008. I was overjoyed. But, at 20 weeks, I suffered a miscarriage,” she says. She conceived again two years later and lost the pregnancy at week 19.

In 2014, she conceived again. “I stopped working, took the right diet, and went for my clinical appointments on time. But, I still miscarried at week 16,” she says.

Like Wangari, many expectant women have had the misfortune of going through a miscarriage.

To stop miscarriage through causes such as cervical incompetence, one of the treatments is the McDonald’s Cerclage — a stitch used to cinch the cervix and prevent it from opening prematurely.

But now, a drug initially designed to tackle diabetes is being praised as the first treatment to prevent a miscarriage. Its effectiveness in treating miscarriages was discovered during clinical trials supervised by University of Warwick’s Medical School and University Hospitals Coventry and Warwickshire in the UK.

According to the findings, treatment worked by increasing the amount of stem cells in the lining of the womb, which improved the capacity to support and hold a pregnancy to full term. “Although miscarriages can result from generic deformities in the embryo, an abnormal uterus lining results in the loss of chromosomal normal pregnancies,” said Pro Jan Brosens, a consultant at Warwick Medical School and University Hospitals Coventry and Warwickshire.

The drug, known as sitagliptin, is in a new class of diabetes drugs called gliptins. It targets an enzyme called DPP4 involved in the recruitment of circulating stem cells to the uterus.

During the drug’s clinical trials, the team of doctors took uterus biopsies of women who had a large number of recurrent miscarriages.

These women were then orally given sitagliptin or a placebo for three menstrual cycles. Those who took the full course of sitagliptin recorded over two-thirds increase in stem cells. “Stem cells are critical in creation of decidual cells in the uterus lining which support the placenta during pregnancy,” said Prof Siobhan Quenby from Warwick Clinical Trials Unit.

According to Dr Beth Wahito, a Kenyan obstetrician, despite the success from these initial trials, the drug will have to undergo secondary, rigorous tests and trials before it can be repurposed and licensed as a form of treatment for miscarriage.