Abstract
Objective: The use of dipeptidyl-peptidase 4 (DPP4) inhibitors and glucagon like peptide 1 (GLP1) analogues for the treatment of diabetic mellitus (DM) type 2 is growing. Currently some of these agents have been approved in combination with insulin. Methods: We considered randomised controlled trials (RCTs) evaluating GLP1 analogues or DDP4 inhibitors combined with basal insulin in diabetic patients. We were limited to trials published in English language. Results: PubMed search retrieved 207 items. After excluding irrelevant items we ended with 7 eligible studies with 1808 participants. Mean baseline HbA1c was 8.5% and median follow up was 24 weeks. Exenatide combined with insulin was used in 2 studies; DPP4 inhibitors were used in 5 studies (2 with sitagliptin, 1 with saxagliptin, 1 with vildagliptin and 1 with alogliptin). Conclusion: Incretin-based therapies combined with basal insulin are able to reduce HbA1c by 0.5-0.7%. DPP4 inhibitors have no significant effect on weight, whereas GLP1 analogues reduced weight by 1-2 kg. Hypoglycaemia rates were generally comparable in all treatment groups. These are promising results, but the available evidence is limited. This is a poorly investigated field with few RCTs. New studies focusing on head-to-head comparisons with short-acting insulin on top of basal insulin are needed.
Keywords: Exenatide, liraglutide, sitagliptin, saxagliptin, vildagliptin, alogliptin, insulin, diabetes mellitus.
Current Vascular Pharmacology
Title:Combination Therapies of DPP4 Inhibitors and GLP1 Analogues with Insulin in Type 2 Diabetic Patients: A Systematic Review
Volume: 11 Issue: 6
Author(s): Evangelos C. Rizos, Evangelia E. Ntzani, Nikolaos Papanas, Vasilis Tsimihodimos, Zoi Mitrogianni, Efstratios Maltezos and Moses S. Elisaf
Affiliation:
Keywords: Exenatide, liraglutide, sitagliptin, saxagliptin, vildagliptin, alogliptin, insulin, diabetes mellitus.
Abstract: Objective: The use of dipeptidyl-peptidase 4 (DPP4) inhibitors and glucagon like peptide 1 (GLP1) analogues for the treatment of diabetic mellitus (DM) type 2 is growing. Currently some of these agents have been approved in combination with insulin. Methods: We considered randomised controlled trials (RCTs) evaluating GLP1 analogues or DDP4 inhibitors combined with basal insulin in diabetic patients. We were limited to trials published in English language. Results: PubMed search retrieved 207 items. After excluding irrelevant items we ended with 7 eligible studies with 1808 participants. Mean baseline HbA1c was 8.5% and median follow up was 24 weeks. Exenatide combined with insulin was used in 2 studies; DPP4 inhibitors were used in 5 studies (2 with sitagliptin, 1 with saxagliptin, 1 with vildagliptin and 1 with alogliptin). Conclusion: Incretin-based therapies combined with basal insulin are able to reduce HbA1c by 0.5-0.7%. DPP4 inhibitors have no significant effect on weight, whereas GLP1 analogues reduced weight by 1-2 kg. Hypoglycaemia rates were generally comparable in all treatment groups. These are promising results, but the available evidence is limited. This is a poorly investigated field with few RCTs. New studies focusing on head-to-head comparisons with short-acting insulin on top of basal insulin are needed.
Export Options
About this article
Cite this article as:
Rizos C. Evangelos, Ntzani E. Evangelia, Papanas Nikolaos, Tsimihodimos Vasilis, Mitrogianni Zoi, Maltezos Efstratios and Elisaf S. Moses, Combination Therapies of DPP4 Inhibitors and GLP1 Analogues with Insulin in Type 2 Diabetic Patients: A Systematic Review, Current Vascular Pharmacology 2013; 11 (6) . https://dx.doi.org/10.2174/15701611113119990103
DOI https://dx.doi.org/10.2174/15701611113119990103 |
Print ISSN 1570-1611 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-6212 |
Call for Papers in Thematic Issues
Ischemic Cardiovascular Diseases: Mechanisms, Diagnosis and Therapy
Ischemic cardiovascular disease includes myocardial infarction, coronary atherosclerotic heart disease, angina pectoris, etc., constitute the leading cause of patient mortality by preventing tissues from getting sufficient oxygen and nutrients. Ischemic heart disease, as a clinical condition, is characterized by myocardial ischemia, causing an imbalance between myocardial blood supply and demand, ...read more
TREATMENT OF CARDIOVASCULAR DISEASE IN CHRONIC AND END STAGE KIDNEY DISEASE
Cardiovascular disease still remains the leading cause of death in Chronic and End Stage Kidney Disease, accounting for more than half of all deaths in dialysis patients. During the past decade, research has been focused on novel therapeutic agents that might delay or even reverse cardiovascular disease and vascular calcification, ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Genomics and Natural Products: Role of Bioinformatics and Recent Patents
Recent Patents on Biotechnology Aspirin: from a Historical Perspective
Recent Patents on Cardiovascular Drug Discovery Herbal Natural Products As a Source of Monoamine Oxidase Inhibitors: A Review
Current Topics in Medicinal Chemistry Gender Differences in Atrial Fibrillation: A Review of Epidemiology, Management, and Outcomes
Current Cardiology Reviews Vascular Disease and Risk Factors in Chronic Kidney Disease
Vascular Disease Prevention (Discontinued) Protein/ Hormone Based Nanoparticles as Carriers for Drugs Targeting Protein-Protein Interactions
Current Topics in Medicinal Chemistry The Interaction Between Burn Injury and Vitamin D Metabolism and Consequences for the Patient
Current Clinical Pharmacology Pro-Inflammatory Mechanisms in Diabetic Neuropathy: Focus on the Nuclear Factor Kappa B Pathway
Current Drug Targets Frailty Among Alzheimer’s Disease Patients
CNS & Neurological Disorders - Drug Targets Potential Targets for Intervention in Radiation-Induced Heart Disease
Current Drug Targets Outcomes of Perilla Seed Oil as an Additional Neuroprotective Therapy in Patients with Mild to Moderate Dementia: A Randomized Control Trial
Current Alzheimer Research Therapeutic Potential of N-Acetylcysteine for Wound Healing, Acute Bronchiolitis, and Congenital Heart Defects
Current Drug Metabolism The Role of CTLA-4 Gene Polymorphisms in Autoimmune Disease Pathogenesis: A 2012 Update
Immunology, Endocrine & Metabolic Agents in Medicinal Chemistry (Discontinued) Peroxisome Proliferator-Activated Receptor (PPAR) in Regenerative Medicine: Molecular Mechanism for PPAR in Stem Cells’ Adipocyte Differentiation
Current Stem Cell Research & Therapy subject Index To Volume 3
Current Protein & Peptide Science Diet and Dysfunctional Metabolism in BB Rats
Immunology, Endocrine & Metabolic Agents in Medicinal Chemistry (Discontinued) Marine n-3 Fatty Acids for Cardiovascular Risk Reduction and Disease Control in Rheumatoid Arthritis: “Kill Two Birds with One Stone”?
Current Pharmaceutical Design Chronic Kidney Disease and the Search for New Biomarkers for Early Diagnosis
Current Medicinal Chemistry Liver Disease in Diabetes Mellitus: Potential Therapeutic Value of Vitamin E-Silybin Phytosomal Complex
Immunology, Endocrine & Metabolic Agents in Medicinal Chemistry (Discontinued) “Potential natural antioxidants: adjuvant effect of green tea polyphenols in periodontal infections”
Infectious Disorders - Drug Targets