Efficacy of GLP-1 Receptor Agonists and DPP-4 Inhibitors: Meta-Analysis and Systematic Review

Aroda, Vanita R.; Henry, Robert R.; Han, Jenny; Huang, Wenying; DeYoung, Mary Beth; Darsow, Tamara; Hoogwerf, Byron J.

doi:10.1016/j.clinthera.2012.04.013

Cited by 229 publications

(182 citation statements)

References 88 publications

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“…It was reported that sitagliptin 50 mg daily and 100 mg daily showed similar improvements in HbA1c [10]. On the other hand, a possible superiority of vildagliptin over other DPP-4 inhibitors regarding a hypoglycemic effect [11,12] was also reported. The IC 50 for vildagliptin and sitagliptin, the concentration required to achieve 50% inhibition of DPP-4 activity, is reportedly 5 nmol/L [13] and 26.3 nmol/L [14], respectively, which suggests that vildagliptin might be a potent DPP-4 inhibitor.…”

Section: Discussionmentioning

confidence: 95%

Dipeptidyl Peptidase-4 Inhibitor Switching as an Alternative Add-on Therapy to Current Strategies Recommended by Guidelines: Analysis of a Retrospective Cohort of Type 2 Diabetic Patients

Tanaka¹,

Nishimura²,

Sekioka³

et al. 2016

J Diabetes Metab

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Objective: This retrospective cohort study aimed to investigate the significance of dipeptidyl peptidase-4 (DPP-4) inhibitor switch therapy, which is currently not recommended by major diabetes guidelines. Methods:The subjects were 238 outpatients with type 2 diabetes who had been prescribed sitagliptin 50 mg daily, which was subsequently changed in one of three ways. Patients whose sitagliptin was switched to vildagliptin 50 mg twice daily were defined as the switched group. Patients whose sitagliptin was increased to 100 mg once daily were defined as the increased group. Patients who received an additional alfa-glucosidase inhibitor (α-GI) three times daily prior to meals and sitagliptin 50 mg once daily were defined as the added group. The primary endpoint was the glycated hemoglobin (HbA1c) value at 6 months after the medication change. Patients whose oral hypoglycemic agents were changed within 6 months after switching to vildagliptin, increasing sitagliptin, or adding α-GI were excluded from the full analysis set and the remaining patients were included in the per protocol analysis. Results:The per protocol analysis revealed that the HbA1c level decreased significantly in the switched group (n=71) and the added group (n=18) but did not change significantly in the increased group (n=69). Analysis of the full set showed that the HbA1c level decreased significantly in all three groups (switched [n=92], increased [n=88], and added [n=25]).

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Section: Discussionmentioning

confidence: 95%

Dipeptidyl Peptidase-4 Inhibitor Switching as an Alternative Add-on Therapy to Current Strategies Recommended by Guidelines: Analysis of a Retrospective Cohort of Type 2 Diabetic Patients

Tanaka¹,

Nishimura²,

Sekioka³

et al. 2016

J Diabetes Metab

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“…The dipeptidyl peptidase-4 (DPP-4) inhibitors have potential advantages in people with CKD as they are associated with a low risk of hypoglycemia and are weight-neutral (103,104). All of the currently available DPP-4 inhibitors can be used in CKD, but sitagliptin, saxagliptin, and alogliptin require downward dose titration based on eGFR (105)(106)(107)(108).…”

Section: Incretinsmentioning

confidence: 99%

Diabetic Kidney Disease: A Report From an ADA Consensus Conference

Tuttle

Bakris

Bilous

et al. 2014

American Journal of Kidney Diseases

644

604

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The incidence and prevalence of diabetes mellitus have grown significantly throughout the world, due primarily to the increase in type 2 diabetes. This overall increase in the number of people with diabetes has had a major impact on development of diabetic kidney disease (DKD), one of the most frequent complications of both types of diabetes. DKD is the leading cause of end-stage renal disease (ESRD), accounting for approximately 50% of cases in the developed world. Although incidence rates for ESRD attributable to DKD have recently stabilized, these rates continue to rise in high-risk groups such as middle-aged African Americans, Native Americans, and Hispanics. The costs of care for people with DKD are extraordinarily high. In the Medicare population alone, DKD-related expenditures among this mostly older group were nearly $25 billion in 2011. Due to the high human and societal costs, the Consensus Conference on Chronic Kidney Disease and Diabetes was convened by the American Diabetes Association in collaboration with the American Society of Nephrology and the National Kidney Foundation to appraise issues regarding patient management, highlighting current practices and new directions. Major topic areas in DKD included 1) identification and monitoring, 2) cardiovascular disease and management of dyslipidemia, 3) hypertension and use of renin-angiotensin-aldosterone system blockade and mineralocorticoid receptor blockade, 4) glycemia measurement, hypoglycemia, and drug therapies, 5) nutrition and general care in advanced-stage chronic kidney disease, 6) children and adolescents, and 7) multidisciplinary approaches and medical home models for health care delivery. This current state summary and research recommendations are designed to guide advances in care and the generation of new knowledge that will meaningfully improve life for people with DKD.

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“…The A1C reduction seen with DPP-4 inhibitors is equivalent to that seen with other oral agents, ranging from −0.6 % to −1.1 % [29]. Overall, there appears to be no difference in terms of A1C reduction nor change in body weight amongst the DPP-4 inhibitors.…”

Section: Dpp-4 Inhibitorsmentioning

confidence: 77%

Impact of Newer Medications for Type 2 Diabetes on Body Weight

Pedersen¹

2013

Curr Obes Rep

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Most patients with type 2 diabetes (T2DM) struggle with excess body weight. Many management strategies for achievement of euglycemia in T2DM are associated with weight gain, which worsens insulin resistance over time, increases health risk associated with obesity, and is associated with poor compliance with treatment. This review will discuss a host of new medications for management of hyperglycemia that have emerged and are emerging which are weight neutral, or facilitate weight loss. Incretin therapies are reviewed, including DPP-4 inhibitors which are weight neutral, and GLP-1 receptor agonists which can facilitate weight loss. SGLT-2 inhibitors, anticipated to become available soon, facilitate modest weight loss. Pramlintide can improve glycemic control and facilitate weight loss in T2DM patients on concomitant insulin therapy. The bile acid sequestering agent colesevelam, more recently approved for management of T2DM, modestly improves glycemic control and is weight neutral. The advent of these newer therapies makes it increasingly possible to optimize concomitant management of type 2 diabetes and obesity.

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Efficacy of GLP-1 Receptor Agonists and DPP-4 Inhibitors: Meta-Analysis and Systematic Review

Abstract: All of the incretin-based therapies in the present meta-analysis were associated with significant reductions from baseline in HbA(1c) and FPG. Further direct comparative studies between the GLP-1RAs and the DPP-4 inhibitors and within the GLP-1RA class are justified.

Cited by 229 publications

References 88 publications

Dipeptidyl Peptidase-4 Inhibitor Switching as an Alternative Add-on Therapy to Current Strategies Recommended by Guidelines: Analysis of a Retrospective Cohort of Type 2 Diabetic Patients

Dipeptidyl Peptidase-4 Inhibitor Switching as an Alternative Add-on Therapy to Current Strategies Recommended by Guidelines: Analysis of a Retrospective Cohort of Type 2 Diabetic Patients

Diabetic Kidney Disease: A Report From an ADA Consensus Conference

Impact of Newer Medications for Type 2 Diabetes on Body Weight

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