DPP-4 inhibitors can help Type 2 diabetics achieve HbA1c goals
MedWire News: Results from a meta-analysis of randomized controlled trials show that a large percentage of patients with Type 2 diabetes who are treated with dipeptidyl peptidase (DPP)-4 inhibitors manage to reach a glycated hemoglobin (HbA1c) target of less than 7%.
Dario Giugliano (Second University of Naples, Italy) and co-workers selected 44 randomized controlled trials of DPP-4 inhibitors (52 reported comparisons) involving 19,101 participants for analysis. Of these, 10,467 participants were treated with a DPP-4 inhibitor (14 trials vildagliptin, 18 trials sitagliptin, eight trials saxagliptin, and four trials alogliptin) and 8634 received placebo or an alternative antidiabetes drug.
To be included in the study, trials had to last for 12 weeks or more, include at least 30 patients with Type 2 diabetes aged 18 years or above/older, report the effect of treatment with DPP-4 inhibitors in comparison with other drugs or placebo, and report the number of people reaching a HbA1c target of less than 7%.
Compared with placebo, DPP-4 inhibitors achieved significantly greater reductions in HbA1c. Overall, approximately 40% of patients treated with DPP-4 inhibitors achieved a HbA1c target below 7%.
With regard to comparator drugs such as metformin, sulfonylureas, or glitazones, DPP-4 inhibitors achieved a similar mean reduction in HbA1c, with comparable rates of hypoglycemia, and no weight gain.
The team notes that patients with a baseline HbA1c of 8% or more were significantly more likely than those with a lower baseline level to achieve the target HbA1c by study completion, although gender, mean age, concomitant oral drug use, and trial duration did not significantly affect target attainment.
Writing in the journal Diabetes, Obesity and Metabolism, the researchers report that patients treated with DPP-4 inhibitors have a greater chance of reaching the HbA1c target of below 7% than those treated with placebo, but a similar chance to those treated with alternative antidiabetic medications.
"Long-term follow up is needed to confirm the promise of these new agents in the treatment of Type 2 diabetes," conclude Giugliano and co-workers.
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By Helen Albert