Comparison of Vildagliptin and Pioglitazone in Korean Patients with Type 2 Diabetes Inadequately Controlled with Metformin

Abstract

BackgroundWe compared the efficacies of vildagliptin (50 mg twice daily) relative to pioglitazone (15 mg once daily) as an add-on treatment to metformin for reducing glycosylated hemoglobin (HbA1c) levels in Korean patients with type 2 diabetes.MethodsThe present study was a multicenter, randomized, active-controlled investigation comparing the effects of vildagliptin and pioglitazone in Korean patients receiving a stable dose of metformin but exhibiting inadequate glycemic control. Each patient underwent a 16-week treatment period with either vildagliptin or pioglitazone as an add-on treatment to metformin.ResultsThe mean changes in HbA1c levels from baseline were –0.94% in the vildagliptin group and –0.6% in the pioglitazone group and the difference between the treatments was below the non-inferiority margin of 0.3%. The mean changes in postprandial plasma glucose (PPG) levels were –60.2 mg/dL in the vildagliptin group and –38.2 mg/dL in the pioglitazone group and these values significantly differed (P=0.040). There were significant decreases in the levels of total, low density lipoprotein, high density lipoprotein (HDL), and non-HDL cholesterol in the vildagliptin group but increases in the pioglitazone group. The mean change in body weight was –0.07 kg in the vildagliptin group and 0.69 kg in the pioglitazone group, which were also significantly different (P=0.002).ConclusionAs an add-on to metformin, the efficacy of vildagliptin for the improvement of glycemic control is not inferior to that of pioglitazone in Korean patients with type 2 diabetes. In addition, add-on treatment with vildagliptin had beneficial effects on PPG levels, lipid profiles, and body weight compared to pioglitazone.

DPP4 Polymorphisms Are Associated With Hypoalphalipoproteine mia and DPP4 Serum Levels. A Case-control Study of the GEA Cohort.

“…Here, we show an association between rs17574 and the presence of high apoB and non-HDL-C levels. Consistent with the observed association between polymorphisms in the DPP4 gene with apoB and non-HDL-C, pharmacological inhibition of DPP4, has been found associated with lower total cholesterol, apoB, triglycerides, non-HDL-C and VLDL levels [55][56][57].…”

Antihyperglycemic Agent Therapy for Adult Patients with Type 2 Diabetes Mellitus 2017: A Position Statement of the Korean Diabetes Association

“…Since the first edition was published in 1990, the Clinical Practice Guidelines for adult patients with T2DM have been periodically updated by the Committee of Clinical Practice Guidelines of the KDA [ 1 ]. However, since the fifth edition was published in 2015, many results from large clinical trials of antidiabetic drugs have been introduced, and clinical evidence from studies assessing Korean patients with T2DM who use dipeptidyl peptidase 4 (DPP4) inhibitors, glucagon-like peptide 1 receptor agonists (GLP-1RAs), or sodium-glucose cotransporter 2 (SGLT2) inhibitors have accumulated [ 2 3 4 5 ]. All novel evidence and results were reviewed to extract recommendations for the treatment of these patients.…”

Efficacy and safety of adding evogliptin versus sitagliptin for metformin‐treated patients with type 2 diabetes: A 24‐week randomized, controlled trial with open label extension

“…In the present study, mean changes in HOMA‐IR from baseline to 24 weeks showed that evoglipitin did not have a statistically significant effect on insulin resistance (−0.17 ± 1.72, P = .1233). In a previous study among Korean T2DM patients, another DPP‐4 inhibitor (vildagliptin) had similar effects when compared to pioglitazone …”

“…In a previous study among Korean T2DM patients, another DPP-4 inhibitor (vildagliptin) had similar effects when compared to pioglitazone. 26 We first verified the tolerability and safety of a daily dose of evogliptin 5 mg up to week 52. The incidence of AEs was similar to that with use of sitagliptin, which is one of the most widely prescribed DPP-4 inhibitors.…”