Emerging role of dipeptidyl peptidase-4 inhibitors in the management of type 2 diabetes.

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Richter B, Bandeira-Echtler E, Bergerhoff K, Lerch C

Emerging role of dipeptidyl peptidase-4 inhibitors in the management of type 2 diabetes.

Vasc Health Risk Manag. 2008;4(4):753-68.

PubMed ID

19065993 [ View in PubMed

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Abstract

BACKGROUND: 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. OBJECTIVES: 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. RESULTS: 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. CONCLUSIONS: 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.

DrugBank Data that Cites this Article

Drugs

Sitagliptin

Drug Targets

Drug	Target	Kind	Organism	Pharmacological Action	Actions
Sitagliptin	Dipeptidyl peptidase 4	Protein	Humans	Yes	Inhibitor	Details