Diabetes drug may help prevent recurrent miscarriage

An NIHR-supported study has found that an existing diabetes drug can be used to optimise the lining of the womb and reduce the risk of miscarriage in women who have already experienced pregnancy loss.

There are very few effective treatments for recurrent miscarriage. If successful, this would be the first drug which specifically at the lining of the womb to prevent miscarriage. Recurrent miscarriage is defined as the loss of two or more consecutive pregnancies, with additional miscarriages decreasing the likelihood of a successful pregnancy.

Previous research revealed a lack of stem cells in the womb lining in women with recurrent miscarriage. Stem cells have been shown to improve renewal of the womb lining and reduce inflammation in early pregnancy.

Researchers at supported by the NIHR Coventry and Warwickshire Clinical Research Facility wanted to find out if a drug designed to tackle diabetes - Sitagliptin - could be re- purposed as the first treatment to prevent miscarriage by increasing the number of stem cells.

In a small clinical trial, 38 women aged 18 to 42 who had experienced a large number of recurrent miscarriages (average five) were given either an oral course of sitagliptin or a placebo for three menstrual cycles. Biopsies of the womb were taken at the start of the treatment and afterwards, to determine the number of stem cells present before and after the course.

The researchers found an average increase in stem cell count of 68% in those women who took the full course of sitagliptin. This compares to no significant increase in those in the control group received an identical placebo pill.

They also saw a 50% decrease in the number of ‘stressed’ cells present in the lining of the womb. There were minimal side effects for the participants.

Although this research was specifically designed to test whether sitagliptin could increase the presence of stem cells in the womb, follow-up of participants found that there were no further losses of normal pregnancies in those who took the drug.

These early results now need to be further tested in a large-scale clinical trial.