First ever treatment for miscarriage linked to diabetes drug

The first ever treatment to prevent miscarriage could be in sight thanks to a clinical trial led by the University of Warwick.

Researchers at the Warwick Medical School showed that by repurposing the diabetes drug sitagliptin they could increase the amount of stem cells in the lining of the womb, improving conditions to support pregnancy.

The drug works by targeting the DPP4 enzyme, which is involved in the recruitment of circulating stem cells to the womb. The new research examined whether inhibiting this enzyme improves conditions in the womb for pregnancy.

Stems cells help create decidual cells in the lining of the womb which support the placenta throughout pregnancy. Insufficient stem cells in the womb lining can lead to an excess of stressed and inflammatory decidual cells, which can cause placental bleeding and miscarriage.   

The clinical trial involved 38 women aged between 18 and 42 who had experienced a large number of recurrent miscarriages. They 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 trial and afterwards to determine if the number of stem cells had increased.

The researchers found stem cells increased on average by 68% in women who took the full course of sitagliptin. More so, they saw a 50% decrease in the number of ‘stressed’ cells present in the lining of the womb.

The team now hopes to take the treatment to clinical trial. If successful, it would be the first trial to specifically target the lining of the womb to prevent miscarriage.

Professor Jan Brosens, of Warwick Medical School and consultant in Reproductive Health at University Hospitals Coventry and Warwickshire NHS Trust, said: “There are currently very few effective treatments for miscarriage and this is the first that aims at normalising the womb before pregnancy. Although miscarriages can be caused by genetic errors in the embryo, an abnormal womb lining causes the loss of chromosomal normal pregnancies. We hope that this new treatment will prevent such losses and reduce both the physical and psychological burden of recurrent miscarriage.”

Jane Brewin, chief executive at miscarriage charity Tommy’s said: “For far too long it has often been said by many health professionals that miscarriage is not preventable, and parents have been left with little hope given the paucity of treatment options available. This situation prompted Tommy’s to invest in the Tommy’s National Centre for Miscarriage Research and this breakthrough research by the world leading team at Warwick shows great promise for an effective treatment which will reduce miscarriage and possibly later pregnancy loss too. A large-scale trial is needed to verify the findings and we hope that this will get underway quickly.”