Effects of vildagliptin on glucose control in patients with type 2 diabetes inadequately controlled with a sulphonylurea*

Garber, Alan J.; Foley, James E.; Banerji, Mary Ann; Ebeling, Peter R.; Guðbjörnsdóttir, Soffia; Camisasca, R.; Couturier, A.; Baron, Michelle A.

doi:10.1111/j.1463-1326.2008.00859.x

Cited by 205 publications

(180 citation statements)

References 24 publications

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“…This may be of interest in patients who cannot be treated with metformin. Compared with a placebo, sitagliptin 100 mg (once daily) [45] and vildagliptin (50 or 100 mg daily) [46] significantly improved glycaemic control and β-cell function, and were well tolerated in T2DM patients with inadequate glycaemic control with glimepiride alone. Similar results were reported in T2DM patients with the addition of alogliptin (12.5 mg or 25 mg) to glyburide [47] and the addition of linagliptin (5mg) to a SU [48].…”

Section: Gliptins Combined With Sulphonylureasmentioning

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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Section: Gliptins Combined With Sulphonylureasmentioning

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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“…This most likely explains why our HbA1c reduction was lower than other reports, since our baseline HbA1c levels were also lower. On the other hand, when used as an add-on agent to ongoing glimepiride therapy, the addition of vildagliptin 50 mg once daily (n = 170) and 50 mg twice daily (n = 169) resulted in similar reductions in HbA1c values, by around 0.6 % after 24 weeks, compared with placebo (n = 176) in diabetic patients with normal kidney function [22]. Similar results were also observed in the present study in patients undergoing HD.…”

Section: Conflicts Of Interest Statementmentioning

confidence: 99%

The dipeptidyl peptidase-4 (DPP-4) inhibitor vildagliptin improves glycemic control in type 2 diabetic patients undergoing hemodialysis

et al. 2011

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Numerous drugs with different mechanisms of action are currently in use with the aim of improving glycemic control, and drugs with different pharmacologic profiles are employed in the management of type 2 diabetes. Therapeutic options for patients with type 2 diabetes and end-stage renal disease (ESRD) are, however, limited because the reduced glomerular filtration rate results in the accumulation of certain drugs and/ or their metabolites [1]. Conventional oral hypoglyce- Abstract. The potent and selective dipeptidyl peptidase-4 inhibitor vildagliptin improves glycemic control in patients with type 2 diabetes through incretin hormone-mediated increases in both α-and β-cell responsiveness to glucose. We conducted a prospective, open-label, parallel group, controlled study of 51 patients with type 2 diabetic patients undergoing hemodialysis (HD) during the 24-week study period. Patients were assigned to two groups: the vildagliptin group (n = 30) and the control group (n = 21). Vildagliptin was administered at 50 mg/day for the first 8 weeks. Then doses were titrated by dose-doubling to a maximum of 100 mg/day if hemoglobin A1c (HbA1c) or glycated albumin (GA) target levels had not been reached. No vildagliptin was administered to the controls. The average final dose of vildagliptin was 80 ± 5 mg daily. After 24 weeks, vildagliptin had decreased average HbA1c levels from 6.7 % baseline to 6.1 %, average GA levels from 24.5 % baseline to 20.5 % and average postprandial plasma glucose levels from 186 mg/dL baseline to 140 mg/dL (all p < 0.0001). In the control group, we observed no such changes. Vildagliptin efficacy did not differ according to age or body mass index, but the GA reduction was significantly greater in the anti-diabetic agents-naïve group. Furthermore, in patients with higher baseline GA levels, a higher vildagliptin dosage was required to produce a noticeable effect. No serious adverse effects such as hypoglycemia or liver impairment were observed in any patient. Vildagliptin was effective as a treatment for diabetic patients undergoing HD.

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“…Vildagliptin has been evaluated as add-on treatment after monotherapy with metformin, 2 glimepiride 3 or pioglitazone 4 has not achieved target HbA 1c . It has been compared with pioglitazone as additional treatment to metformin.…”

Section: Clinical Trialsmentioning

confidence: 99%

“…It has been compared with pioglitazone as additional treatment to metformin. 5 The protocols in the three addon trials [2][3][4] were similar and all were double blind. Patients with HbA 1c 7.5-11.0 per cent after at least three months' treatment with the baseline drug were randomised to placebo or vildagliptin 50mg once or twice daily.…”

Section: Clinical Trialsmentioning

confidence: 99%

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Vildagliptin: alternative add‐on therapy for oral glycaemic control

Chaplin¹,

Campbell²

2008

Prescriber

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Vildagliptin, an oral DPP‐4 inhibitor, is licensed as an add‐on therapy when adequate glycaemic control has not been achieved with metformin, a sulphonylurea or a glitazone. In our New products review Steve Chaplin presents the clinical data relating to its efficacy and adverse effects, and Professor Ian Campbell comments on its place in type 2 diabetes therapy. Copyright © 2008 Wiley Interface Ltd

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Effects of vildagliptin on glucose control in patients with type 2 diabetes inadequately controlled with a sulphonylurea*

Cited by 205 publications

References 24 publications

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

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

The dipeptidyl peptidase-4 (DPP-4) inhibitor vildagliptin improves glycemic control in type 2 diabetic patients undergoing hemodialysis

Vildagliptin: alternative add‐on therapy for oral glycaemic control

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