Efficacy and safety of sitagliptin monotherapy and combination therapy in Japanese type 2 diabetes patients

Journal of Diabetes Investigation

Akira Kubota²  Hajime Maeda²  Akira Kanamori²  Kiyokazu Matoba²  Yasuyuki Jin²  Fuyuki Minagawa²  Mitsuo Obana²  Kotaro Iemitsu²  Shogo Ito²  Hikaru Amamiya²  Mizuki Kaneshiro²  Masahiko Takai²  Hideaki Kaneshige²  Kazuhiko Hoshino²  Masashi Ishikawa²  Nobuaki Minami²  Tetsuro Takuma²  Nobuo Sasai²  Sachio Aoyagi²  Takehiro Kawata²  Atsuko Mokubo²  Hiroshi Takeda²  Shin Honda²  Hideo Machimura²  Tetsuya Motomiya²  Manabu Waseda²  Yoshikazu Naka²  Yasushi Tanaka³  Yasuo Terauchi¹ 

[1] Department of Endocrinology and Diabetes, Yokohama City University Medical Center, Kanagawa, Japan;The Study Group of the Diabetes Committee, Kanagawa Physicians Association;Division of Metabolism and Endocrinology, Department of Internal Medicine, St. Marianna University School of Medicine

关键词: Diabetes mellitus;    Sitagliptin;    Sulfonylurea;   

DOI  :  10.1111/j.2040-1124.2012.00221.x

来源: Wiley

【 摘 要 】

Abstract

(J Diabetes Invest, doi: 10.1111/j.2040-1124.2012.00221.x, 2012)

Aims/Introduction:  To determine the efficacy and safety of sitagliptin monotherapy and combination therapy in Japanese type 2 diabetes patients after 3 months’ therapy.

Materials and Methods:  A retrospective, observational study of 741 type 2 diabetes patients was carried out; 110 received sitagliptin monotherapy, and 631 received combination therapy with sitagliptin when other oral medications were insufficient. The primary outcome measure was glycated hemoglobin (HbA_1c) measured at 0, 4 and 12 weeks of sitagliptin therapy.

Results:  In the monotherapy and combination therapy groups, HbA_1c decreased significantly after 12 weeks. Target HbA_1c (<7%) was achieved in 39.1% overall. On logistic regression analysis, baseline HbA_1c was the strongest contributing factor for achieving target HbA_1c; baseline body mass index and duration of diabetes were also significant factors. A total of 82 patients (11%) were unresponsive to sitagliptin. These patients’ baseline body mass index was significantly higher and their baseline HbA_1c was significantly lower than those of patients who responded to sitagliptin. The most commonly co-administered drugs were sulfonylureas (508 patients). In these patients, the dose of sulfonylurea decreased with time. In 66 patients whose sulfonylurea dosage was reduced when sitagliptin was started, HbA_1c and bodyweight decreased significantly after 12 weeks. A total of 24 patients receiving sulfonylureas had mild hypoglycemia, but none discontinued sitagliptin.

Conclusions:  Sitagliptin was effective and safe as both monotherapy and combination therapy in Japanese type 2 diabetes patients. When sulfonylureas were ineffective, sitagliptin improved glycemic control. In patients whose sulfonylurea dose was reduced at the start of sitagliptin, blood glucose improved and bodyweight decreased after 12 weeks.

【 授权许可】

Unknown   
© 2012 Asian Association for the Study of Diabetes and Wiley Publishing Asia Pty Ltd