Vildagliptin plus metformin combination therapy provides superior glycaemic control to individual monotherapy in treatment‐naive patients with type 2 diabetes mellitus

Bosi, Emanuele; Dotta, Francesco; Jia, Yongliang; Goodman, Matthew M.

doi:10.1111/j.1463-1326.2009.01040.x

Cited by 163 publications

(137 citation statements)

References 24 publications

Supporting

Mentioning

110

Contrasting

Unclassified

Order By: Relevance

“…The initial combination of sitagliptin (2 × 50 mg) or vildagliptin (2 × 50 mg) with metformin (low dose of 2 × 500 mg or high dose of 2 × 1000 mg) had superior efficacy compared with monotherapy treatments, with comparable overall tolerability profiles and low risk of hypoglycaemia [13][14][15][19][20][21]71]. Similar results were obtained with the initial combination of saxagliptin 5 or 10 mg plus metformin 500 mg uptitrated to 2000 mg [20,21].…”

Section: Gliptins As the Initial Combinationsupporting

confidence: 55%

“…As metformin is considered the first-line drug therapy for the management of T2DM [10,11], it is of interest to compare the efficacy (and safety) of aDPP-4 inhibitor with that of metformin in drug-naive T2DM patients insufficiently controlled with diet and exercise [12][13][14][15][16][17][18][19][20][21]. Overall, metformin (1000-2000 mg/day) demonstrated slightly (but significantly) greater reductions in both HbA 1c and body weight ( Table 1, Fig.…”

Section: Gliptins As Monotherapymentioning

confidence: 99%

“…Several clinical trials have evaluated initial combinations of either metformin + gliptin [13][14][15][19][20][21]71] or TZD + gliptin [22,23,58,72] and compared the results with an initial monotherapy (Table 1). However, none of these trials evaluated an initial combination including a DPP-4 inhibitor vs another initial combination not including a gliptin in a head-to-head comparison.…”

Section: Gliptins As the Initial Combinationmentioning

confidence: 99%

See 2 more Smart Citations

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

Scheen¹

2012

Diabetes & Metabolism

176

124

View full text Add to dashboard Cite

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 ...

show abstract

Section: Gliptins As the Initial Combinationsupporting

confidence: 55%

Section: Gliptins As Monotherapymentioning

confidence: 99%

Section: Gliptins As the Initial Combinationmentioning

confidence: 99%

See 1 more Smart Citation

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

Scheen¹

2012

Diabetes & Metabolism

176

124

View full text Add to dashboard Cite

show abstract

“…selective inhibition of DPP-4 resulting in a physiological increase in active GLP-1 levels, they differ by some PK properties 29,30 . Most of them are also available as fixed dose combination (FDC) with metformin, especially vildagliptin 31,32 , sitagliptin 33,34 and saxagliptin 35 . FDC can offer convenience, reduce the pill burden and simplify administration regimens for the patient, all conditions that may improve adherence to therapy [36][37][38] .…”

Section: Introductionmentioning

confidence: 99%

Linagliptin plus metformin: a pharmacokinetic and pharmacodynamic evaluation

Scheen

2013

Expert Opinion on Drug Metabolism & Toxicology

View full text Add to dashboard Cite

SUMMARYIntroduction : The first-choice drug therapy in the management of type 2 diabetes is metformin. However, most patients require a combined therapy to reach and/or maintain targets of glucose control. Dipeptidylpeptidase-4 (DPP-4) inhibitors, commonly referred to as gliptins, offer new options for combined therapy with metformin. Linagliptin is the most recent launched gliptin, with a unique pharmacokinetic profile characterized by negligible renal excretion, and is now also available as a fixed-dose combination (FDC) with metformin.Area covered: An extensive literature search was performed to analyze the potential pharmacokinetic (PK) and pharmacodynamic (PD) interactions between linagliptin and metformin. Linaglipin and metformin may be administered together, either separately or as FDC supported by bioequivalence studies. Linagliptin and metformin are not prone to PK drug-drug interactions. Their co-administration improves blood glucose control more potently than either compound separately, without hypoglycemia and without increasing metforminrelated gastrointestinal side effects.Expert Opinion : The combination linaglitpin plus metformin, if not contraindicated (renal failure), may be used as first-line or second-line therapy in the management of type 2 diabetes.

show abstract

“…Similar doses of metformin were used in studies conducted by Schweizer et al, Goke et al, Bosi et al, Schweizer et al conducted a study comparing 100 mg of vildagliptin daily versus 1500 mg of metformin daily, in drug naïve elderly patient of T2DM mellitus. 23,24,26,28 The mean reductions of FPG in vildagliptin and metformin groups were 37.84 mg/dL and 39.33 mg/dL respectively ( Table 3).…”

Section: Discussionmentioning

confidence: 99%

A comparative study of efficacy and safety of vildagliptin against metformin in newly diagnosed patients of type 2 diabetes mellitus

et al. 2016

View full text Add to dashboard Cite

Background: Diabetes mellitus is a progressive disease characterised by declining β-cell function. Cornerstone of effective management of T2DM is maintaining strict glycaemic control through agency of various oral hypo-glycaemic agents (OHAs). Metformin (a biguanide) currently forms the preferred treatment in newly diagnosed patients of T2DM. Vildagliptin is a potent, orally administered, competitive and reversible inhibitor of DPP-4, which was launched in 2006 and is now approved in more than 70 countries worldwide.Methods: The study was a single blinded study conducted in a district level tertiary care hospital attached to a medical teaching institute. Newly diagnosed patients were screened and randomised in two groups. Group 1 received metformin (500 mg) twice daily and group 2 received vildagliptin (50 mg) twice daily. FPG, PPPG, HbA1c and Weight were assessed on week 0 and week 12.Results: At the end of 12 weeks, ∆FPG was 39.33±4.72mg/dL and 37.84±6.58mg/dL with metformin and vildagliptin respectively. ∆PPPG was 73.88±13.80 mg/dL and 65.08±13.00mg/dL with metformin and vildagliptin. ∆HbA1c was 1.12±0.46 and 0.95±0.32 with metformin and vildagliptin. ∆Weight was 1.02±0.90 Kg with metformin and 0.69±1.33 Kg.Conclusions: Vildagliptin offers an alternative mode of therapy for newly diagnosed, obese patients of type 2 DM, especially those with impaired fasting plasma glucose.

show abstract

Vildagliptin plus metformin combination therapy provides superior glycaemic control to individual monotherapy in treatment‐naive patients with type 2 diabetes mellitus

Cited by 163 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

Linagliptin plus metformin: a pharmacokinetic and pharmacodynamic evaluation

A comparative study of efficacy and safety of vildagliptin against metformin in newly diagnosed patients of type 2 diabetes mellitus

Contact Info

Product

Resources

About