Comparison of vildagliptin and pioglitazone in patients with type 2 diabetes inadequately controlled with metformin

Bolli, Geremia B.; Dotta, Francesco; Colin, Laurence; Minic, Biljana; Goodman, Matthew M.

doi:10.1111/j.1463-1326.2008.01023.x

Cited by 99 publications

(71 citation statements)

References 18 publications

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“…The characteristics and outcomes of the trials are reported in Tables 1 and 2. 14,15,[17][18][19][20][21][22][23][24][25][26][27] In the 17 available trials for lipid parameters, Kendall's tau value suggested major publication bias. Not RCT n=14…”

Section: Resultsmentioning

confidence: 97%

DPP-4 Inhibitors and Lipids: Systematic Review and Meta-Analysis

et al. 2011

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Section: Resultsmentioning

confidence: 97%

DPP-4 Inhibitors and Lipids: Systematic Review and Meta-Analysis

et al. 2011

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“…For example, sitagliptin was well tolerated with no increased risk of hypoglycemia as an add-on to pioglitazone versus pioglitazone monotherapy (incidence rate: 1.1% vs. 0%), 35 as add-on to metformin versus metformin monotherapy (1.3% vs 2.1%), 36 as add-on to metformin versus sitagliptin monotherapy (no hypoglycemia events in either group), 37 and as add-on to metformin versus glipizide plus metformin (4.9% vs. 32.0%). 38 Similarly, there was a low incidence of hypoglycemia with vildagliptin plus metformin compared with pioglitazone plus metformin (0.3% vs. 0%) 39 and compared with metformin monotherapy (0% vs 0.7%). 40 The current analysis supports these findings, demonstrating that the DPP-4 inhibitors are well tolerated with a low risk of hypoglycemia when used as monotherapy or add-on to OAD therapy.…”

Section: ■■ Discussionmentioning

confidence: 99%

Tolerability of Saxagliptin in Patients with Inadequately Controlled Type 2 Diabetes: Results from 6 Phase III Studies

Davidson

2014

JMCP

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“…However, in the present review, only head-to-head trials vs active comparators are presented in brief. Gliptins have also been compared with SUs (glimepiride, glipizide, gliclazide) [27][28][29][30][31][32][33][34], TZDs (pioglitazone 30 mg, rosiglitazone 8 mg) [35][36][37][38][39] and GLP-1 receptor agonists (exenatide, liraglutide) [36,40,41]. However, only one head-to-head study compared two different DPP-4 inhibitors in the same trial: saxagliptin 5 mg with sitaglitptin 100 mg as add-ons to basal metformin therapy [42].…”

Section: Gliptins Combined With Metforminmentioning

confidence: 99%

DPP-4 inhibitors in the management of type 2 diabetes: A critical review of head-to-head trials

Scheen¹

2012

Diabetes & Metabolism

176

124

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Dipeptidyl peptidase-4 (DPP-4) inhibitors offer new options for the management of type 2 diabetes. Direct comparisons with active glucose-lowering comparators in drug-naive patients have demonstrated that DPP-4 inhibitors exert slightly less pronounced HbA 1c reduction than metformin (with the advantage of better gastrointestinal tolerability) and similar glucose-lowering effects as with a thiazolidinedione (TZD; with the advantage of no weight gain). In metformin-treated patients, gliptins were associated with similar HbA 1c reductions compared with a sulphonylurea (SU; with the advantage of no weight gain, considerably fewer hypoglycaemic episodes and no need for titration) and a TZD (with the advantage of no weight gain and better overall tolerability). DPP-4 inhibitors also exert clinically relevant glucose-lowering effects compared with a placebo in patients treated with SU or TZD (of potential interest when metformin is either not tolerated or contraindicated), and as oral triple therapy with a good tolerability profile when added to a metformin-SU or pioglitazone-SU combination. Several clinical trials also showed a consistent reduction in HbA 1c when DPP-4 inhibitors were added to basal insulin therapy, with no increased risk of hypoglycaemia. Because of the complex pathophysiology of type 2 diabetes and the complementary actions of glucose-lowering agents, initial combination of a DPP-4 inhibitor with either metformin or a glitazone may be applied in drug-naive patients, resulting in greater efficacy and similar safety compared with either drug as monotherapy. However, DPP-4 inhibitors were less effective than GLP-1 receptor agonists for reducing HbA 1c and body weight, but offer the advantage of being easier to use (oral instead of injected administration) and lower in cost. Only one head-tohead trial demonstrated the non-inferiority of saxagliptin vs sitagliptin. Clearly, more trials of direct comparisons between different incretin-based therapies are needed. Because of their pharmacokinetic characteristics, pharmacodynamic properties (glucose-dependent glucose-lowering effect) and good overall tolerability profile, DPP-4 inhibitors may have a key role to play in patients with renal impairment and in the elderly. The role of DPP-4 inhibitors in the therapeutic armamentarium of type 2 diabetes is rapidly evolving as their potential strengths and weaknesses become better defined mainly through controlled clinical trials. Keywords:Clinical trial-DPP-4 inhibitor; Alogliptin; Linagliptin; Saxagliptin; Sitagliptin; Vildagliptin; Type 2 diabetes mellitus; Review Résumé Les inhibiteurs de la DPP-4 dans le traitement du diabète de type 2 : revue critique des essais cliniques contrôlés.Les inhibiteurs de la dipeptidylpeptidase-4 (DPP-4) offrent de nouvelles options pour le traitement du diabète de type 2. Des comparaisons directes avec d'autres médicaments antidiabétiques chez des patients naïfs de tout traitement ont démontré que les inhibiteurs de la DPP-4 étaient un peu moins puissants pour diminuer ...

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Comparison of vildagliptin and pioglitazone in patients with type 2 diabetes inadequately controlled with metformin

Abstract: When added to metformin, vildagliptin demonstrates favourable safety and tolerability over 1 year. Vildagliptin provided additional HbA(1c) lowering to that achieved with metformin alone and comparable to that achieved with pioglitazone, with only pioglitazone causing weight gain.

Cited by 99 publications

References 18 publications

DPP-4 Inhibitors and Lipids: Systematic Review and Meta-Analysis

DPP-4 Inhibitors and Lipids: Systematic Review and Meta-Analysis

Tolerability of Saxagliptin in Patients with Inadequately Controlled Type 2 Diabetes: Results from 6 Phase III Studies

DPP-4 inhibitors in the management of type 2 diabetes: A critical review of head-to-head trials

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