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Review
. 2020 Aug:109:154295.
doi: 10.1016/j.metabol.2020.154295. Epub 2020 Jun 15.

The efficacy and safety of dipeptidyl peptidase-4 inhibitors compared to other oral glucose-lowering medications in the treatment of type 2 diabetes

Anca Pantea Stoian  1 , Alexandros Sachinidis  2 , Roxana Adriana Stoica  1 , Dragana Nikolic  3 , Angelo Maria Patti  3 , Ali A Rizvi  4
Affiliations
Review

The efficacy and safety of dipeptidyl peptidase-4 inhibitors compared to other oral glucose-lowering medications in the treatment of type 2 diabetes

Anca Pantea Stoian et al. Metabolism. 2020 Aug.

Abstract

Introduction: The dipeptidyl peptidase-4 inhibitors (DPP-4is), which belong to the class of incretin-based medications, are recommended as second or third-line therapies in guidelines for the management of type 2 diabetes mellitus. They have a favorable drug tolerability and safety profile compared to other glucose-lowering agents.

Objective: This review discusses data concerning the use of DPP-4is and their cardiovascular profile, and gives an updated comparison with the other oral glucose-lowering medications with regards to safety and efficacy. Currently available original studies, abstracts, reviews articles, systematic reviews and meta-analyses were included in the review.

Discussion: DPP4is are moderately efficient in decreasing the HbA1c by an average of 0.5% as monotherapy, and 1.0% in combination therapy with other drugs. They have a good tolerability and safety profile compared to other glucose-lowering drugs. However, there are possible risks pertaining to acute pancreatitis and pancreatic cancer.

Conclusion: Cardiovascular outcome trials thus far have proven the cardiovascular safety for ischemic events in patients treated with sitagliptin, saxagliptin, alogliptin, linagliptin and vildagliptin. Data showing increased rate of hospitalisation in the case of saxagliptin did not seem to be a class effect.

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Conflict of interest statement

Declaration of competing interest The authors have given talks, attended conferences and participated in several advisory boards and trials sponsored by various pharmaceutical companies. Prof. APS is currently Vice President of Romanian National Diabetes Committee. The authors declare no conflict of interest, financial or otherwise.

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