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Emerging role of dipeptidyl peptidase-4 inhibitors in the management of type 2 diabetes
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Emerging role of dipeptidyl peptidase-4 inhibitors in the management of type 2 diabetes
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Journal Article
Emerging role of dipeptidyl peptidase-4 inhibitors in the management of type 2 diabetes
2008
Overview
In type 2 diabetes mellitus (T2DM) there is a progressive loss of beta-cell function. One new approach yielding promising results is the use of the orally active dipeptidyl peptidase-4 (DPP-4) inhibitors. However, every new compound for T2DM has to prove long-term safety especially on cardiovascular outcomes.
Systematic review and meta-analysis of the effects of sitagliptin and vildagliptin therapy on main efficacy parameters and safety. SELECTION CRITERIA, DATA COLLECTION, AND ANALYSIS: Randomized controlled clinical studies of at least 12 weeks' duration in T2DM.
DPP-4 inhibitors versus placebo showed glycosylated hemoglobin A1c (A1c) improvements of 0.7% versus placebo but not compared to monotherapy with other hypoglycemic agents (0.3% in favor of controls). The overall risk profile of DPP-4 inhibitors was low, however a 34% relative risk increase (95% confidence interval 10% to 64%, P = 0.004) was noted for all-cause infection associated with sitagliptin use. No data on immune function, health-related quality of life and diabetic complications could be extracted.
DPP-4 inhibitors have some theoretical advantages over existing therapies with oral antidiabetic compounds but should currently be restricted to individual patients. Long-term data on cardiovascular outcomes and safety are needed before widespread use of these new agents.
Publisher
Taylor & Francis Ltd,Dove Press,Dove Medical Press
Subject
/ Adamantane - analogs & derivatives
/ Adamantane - pharmacokinetics
/ Adamantane - therapeutic use
/ Diabetes
/ Diabetes Mellitus, Type 2 - drug therapy
/ Diabetes Mellitus, Type 2 - enzymology
/ Dipeptidyl Peptidase 4 - metabolism
/ Dipeptidyl-Peptidase IV Inhibitors - adverse effects
/ Dipeptidyl-Peptidase IV Inhibitors - pharmacokinetics
/ Dipeptidyl-Peptidase IV Inhibitors - therapeutic use
/ Glycated Hemoglobin - metabolism
/ Humans
/ Hypoglycemic Agents - adverse effects
/ Hypoglycemic Agents - pharmacokinetics
/ Hypoglycemic Agents - therapeutic use
/ Pyrazines - pharmacokinetics
/ Pyrrolidines - adverse effects
/ Pyrrolidines - pharmacokinetics
/ Pyrrolidines - therapeutic use
/ Review
