Sitagliptin Compared to Thiazolidinediones as a Third-Line Oral Anti-Hyperglycemic Agent in Type 2 Diabetes Mellitus
Endocrine Practice, 05/12/2011Hsia SH et al.
Among ethnic minority type 2 diabetic patients poorly controlled on maximum tolerated doses of metformin and sulfonylureas, third–line add–on therapy with a thiazolidinedione (TZD) controlled hyperglycemia more effectively than sitagliptin after 4 months.
In an open–label, single arm design, the authors treated 108 type 2 diabetic subjects who were sub–optimally controlled on maximum tolerated doses of metformin plus sulfonylureas with addition of sitagliptin 100 mg daily, and compared their responses against a historical control group of 104 similar patients treated with rosiglitazone (8 mg) or pioglitazone (45 mg) daily as their third–line oral agent.
Subjects were assessed bi–monthly, and those who achieved HbA1c < 7.5% at 4 months were continued through 1 year of follow–up.
At baseline, sitagliptin– and TZD–treated subjects had identical HbA1c (±SD) levels (9.4 ±1.8% and 9.4 ±1.9%, respectively) and similar known diabetes duration (6.7 ±5.0 and 7.6 ± 5.8 years, respectively).
HbA1c was reduced in both groups at 4 months (p<0.001), but the reduction was greater with TZDs than sitagliptin (–2.0 ±1.7% vs. –1.3 ±1.8%; p=0.006), as was the proportion of subjects achieving HbA1c < 7.5% (61.5% vs. 46.1%; p=0.026).
Of all subjects achieving HbA1c < 7.5% at 4 months, the same proportions in each group sustained their Hb1c < 7.5% by 12 months (59.1% vs. 57.8%). Sitagliptin was well tolerated.
MDLinx connects healthcare professionals and patients to tomorrow's important medical news, while providing the pharmaceutical and healthcare industries with highly targeted interactive marketing, education, content, and medical research solutions.