Initial therapy with the fixed‐dose combination of sitagliptin and metformin results in greater improvement in glycaemic control compared with pioglitazone monotherapy in patients with type 2 diabetes

Wainstein, Julio; Katz, Leonid; Engel, Samuel S.; Xu, Lixia; Golm, Gregory T.; Hussain, Shehla; O’Neill, Edward A.; Kaufman, Keith D.; Goldstein, Barry J.

doi:10.1111/j.1463-1326.2011.01530.x

Cited by 45 publications

(31 citation statements)

References 42 publications

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“…However, a number of trials included patients with higher baseline HbA 1c levels, which might have resulted in greater HbA 1c reductions during the study. Indeed, baseline HbA 1c levels reported by Pfützner et al [52] were 8.0–12.0%, Derosa et al [53] >8.0%, Pérez-Monteverde et al [54] 7.5–12.0%, Wainstein et al [55] 7.5–12.0%, Jadzinsky et al [56] 8.0–12.0%, and Yoon et al [57] 8.0–12.0%. The majority of trials included patients with body mass index (BMI) ≤40 kg/m 2 .…”

Section: Resultsmentioning

confidence: 99%

Comparative Effectiveness of Dipeptidylpeptidase-4 Inhibitors in Type 2 Diabetes: A Systematic Review and Mixed Treatment Comparison

Craddy

Palin²,

Johnson³

2014

Diabetes Ther

109

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ObjectiveTo compare the safety and efficacy of the dipeptidylpeptidase-4 (DPP-4) inhibitors in patients with type 2 diabetes and inadequate glycemic control.DesignSystematic review of randomized controlled trials (RCTs), health economic evaluation studies, systematic reviews, and meta-analyses, followed by primary Bayesian mixed treatment comparison meta-analyses (MTCs), and secondary frequentist direct-comparison meta-analyses using a random-effects model. Outcomes were reported as weighted mean change from baseline, or odds ratio (OR) with 95% credible interval.Data sourcesMEDLINE, MEDLINE In-Process, EMBASE, and BIOSIS via Dialog ProQuest; Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews via EBSCO; four diabetes and two technical congress abstracts; and health technology assessment organization websites.Eligibility criteriaPatients with type 2 diabetes and inadequate glycemic control receiving any pharmacological anti-diabetic treatment.Data extraction and analysisTitle/abstracts were reviewed for eligibility, followed by full-text review of publications remaining after first pass. A three-person team filtered articles and an independent reviewer checked a random selection (10%) of filtered articles. Data extraction and quality assessment of studies were also independently reviewed. Five DPP-4 inhibitors (alogliptin, linagliptin, saxagliptin, sitagliptin, and vildagliptin) were compared via meta-analysis (where data were available) as monotherapy, dual therapy (plus metformin, sulfonylurea, pioglitazone, or insulin), and triple therapy (plus metformin/sulfonylurea).ResultsThe review identified 6,601 articles; 163 met inclusion criteria and 85 publications from 83 RCTs contained sufficient or appropriate data for analysis. MTCs demonstrated no differences between DPP-4 inhibitors in mean change from baseline in glycosylated hemoglobin (HbA1c) or body weight, or the proportions of patients achieving HbA1c <7% or experiencing a hypoglycemic event, apart from in patients on alogliptin plus metformin, who achieved HbA1c <7% more frequently than those treated with saxagliptin plus metformin [OR 6.41 (95% CI 3.15–11.98) versus 2.17 (95% CI 1.56–2.95)].ConclusionsThis systematic review and MTC showed similar efficacy and safety for DPP-4 inhibitors as treatment for type 2 diabetes, either as monotherapy or combination therapy.Electronic supplementary materialThe online version of this article (doi:10.1007/s13300-014-0061-3) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Comparative Effectiveness of Dipeptidylpeptidase-4 Inhibitors in Type 2 Diabetes: A Systematic Review and Mixed Treatment Comparison

Craddy

Palin²,

Johnson³

2014

Diabetes Ther

109

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“…There was a significant reduction in HbA1c level and the between-group difference in change from baseline body weight between the sitagliptin/ metformin group and the pioglitazone group was 4.5 kg [35]. The weight benefits of metformin monotherapy have been demonstrated in several trials reporting a 0.6-to 2.9-kg weight reduction in diabetic patients followed for 6 months to 5 yr; most of this weight loss occurred within the first year.…”

Section: F) Metforminmentioning

confidence: 94%

“…The mean weight change in metformintreated patients compared with placebo-treated patients was ~4.8 % of the initial body weight in adults and ~4.1% in children. Surprisingly, the beneficial effects of metformin were strikingly more pronounced in Asian patients than in Hispanic patients [35]. METS study (The Use of Metformin in the Treatment of Antipsychotic-Induced Weight Gain in Schizophrenia) will provide more information about the use of Metormin in non-diabetic patients taking anti-psychotic medications.…”

Section: F) Metforminmentioning

confidence: 98%

“…A study conducted by Wainstein et al [35] on 521 patients comparing the safety and efficacy of initial treatment with combination of sitagliptin and metformin with pioglitazone monotherapy in drug-naïve patients with type 2 diabetes mellitus. There was a significant reduction in HbA1c level and the between-group difference in change from baseline body weight between the sitagliptin/ metformin group and the pioglitazone group was 4.5 kg [35].…”

Section: F) Metforminmentioning

confidence: 99%

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Current Updates in the Medical Management of Obesity

Khan¹,

Raza²,

Khan³

et al. 2012

EMI

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Obesity is a chronic medical condition that is expected to become an indirect but leading cause of mortality and morbidity. Obesity results in type 2 diabetes mellitus, insulin resistance, hypertension, dyslipidemia, coronary heart disease. These factors contribute to cardiovascular disease that is a leading cause of death. Therefore, the approach to obesity therapy should be designed to reduce cardiovascular disease risk and mortality. Diet and lifestyle changes remain the cornerstones of therapy for obesity, but the resultant weight loss is often small. For more effective weight loss, individuals have shown to benefit from anti-obesity medications. Anti-Obesity therapy is considered for individuals with a body mass index greater than 30 kg/m2 or ranging from 25 to 30 kg/m2, or individuals with co-morbid conditions. Recent anti-obese medications affect biological mechanisms that suppress appetite and absorb nutrients to regulate body weight. In this review, we discuss the FDA approved anti-obesity drugs and recent patents which include phentermine/topiramate, pramlintide, lorcaserin, AOD9604, oleoyl-estrone, trk-beta antagonists and melanin concentrating hormone that can reduce adiposity at the molecular level.

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“…These effects depend on baseline C-peptide levels. Weinstain et al [9] had observed that Sitagliptin/metformin led to weight loss (-1.4 kg), while pioglitazone led to weight gain (3.0 kg) (p < 0.001 for the between-group difference).…”

Section: Methodsmentioning

confidence: 99%

A Croos Sectional Study in North Eastern Uttar Pradesh Population for the Estimation of Hdl, Triglycerides Levels in Recently Diagnosed Patients With Diabetes Mellitus Type 2 Taking Metformin Alone, Metformin With Add on Sitagliptin and Sitagliptin Alone

Neerjesh¹

2017

WJPR

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Initial therapy with the fixed‐dose combination of sitagliptin and metformin results in greater improvement in glycaemic control compared with pioglitazone monotherapy in patients with type 2 diabetes

Abstract: Compared with pioglitazone, initial therapy with a FDC of sitagliptin and metformin led to significantly greater improvement in glycaemic control as well as a higher incidence of prespecified gastrointestinal adverse events, a lower incidence of oedema and weight loss vs. weight gain.

Cited by 45 publications

References 42 publications

Comparative Effectiveness of Dipeptidylpeptidase-4 Inhibitors in Type 2 Diabetes: A Systematic Review and Mixed Treatment Comparison

Comparative Effectiveness of Dipeptidylpeptidase-4 Inhibitors in Type 2 Diabetes: A Systematic Review and Mixed Treatment Comparison

Current Updates in the Medical Management of Obesity

A Croos Sectional Study in North Eastern Uttar Pradesh Population for the Estimation of Hdl, Triglycerides Levels in Recently Diagnosed Patients With Diabetes Mellitus Type 2 Taking Metformin Alone, Metformin With Add on Sitagliptin and Sitagliptin Alone

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