Diabetes In Control. A free weekly diabetes newsletter for Medical Professionals. News and information for Medical Professionals.
Editor's Note
It has been 10 years since Sitagliptin was approved by the FDA. When it was first approved there was a lot of pushback from prescribers to trying a new class, as the last class, the TZDs, had suffered through the problems with Rezulin and the cardiovascular problems associated with Actos and Avandia.
Although sales started slowly, the drug known as Januvia became a billion dollar blockbuster for Merck, and many other companies have tried to capture some of Januvia’s success with their own versions of a DPP-4I.
There are currently eleven approved DPP-4I available around the world, and the list is continuing to grow as another three are in development. In addition, Merck has a once a week version, omarigliptin, available in Japan.
This month we have an overview of the available ones, as well as ways to adjust dosing for special populations.
Dave Joffe
Editor-in-chief
DPP-4 Inhibitors offer some advantages over existing oral options for the management of type 2 diabetes such as a negligible risk of hypoglycemia compared with sulfonylureas and, in general, a weight-neutral profile.
Forms, dosages and dosing considerations for pregnancy, breastfeeding, hepatic and renal.
Data from 2 trials show long-term use can improve albumin/creatinine ratio, but not other renal outcomes.
Initiation of glucagon like peptide-1 agonists may increase risk of gallbladder or bile duct disease and cholecystectomy; no increased risk associated with DPP-4 inhibitor therapy.