Roger Gadsby

GP Nuneaton, Warwickshire U.K. and Associate Clinical Professor, Warwick Medical School, University of Warwick, U.K.

Abstract

Background:  Sitagliptin was launched into the UK Market in 2007, as the fi rst member of a new class of oral glucose lowering medications, the Dipetidyl Peptidase 4 inhibitors.

Aim:  To review the efficacy and safety of sitagliptin and discuss its place in therapy.

Method:  Expert review using published reviews and papers published on sitagliptin, information on guideline recommendations for sitagliptin and DPP4 inhibitors, and discussion of the author’s use of the agent.

Results:  Evidence from a Cochrane review and meta-analysis of 14 trials or study arms suggests that sitagliptin lowers HBA1c by 0.7% in sitagliptin versus placebo trials. Evidence from a pooled safety database of 3415 people taking sitagliptin, and the Cochrane review show that the drug is well tolerated, causes no hypoglycaemia and is weight neutral. No specific signals of concern for the safety of sitagliptin have so far arisen in the pooled database. Guidelines recommend its use in triple therapy with metformin and sulphonylurea in dual therapy with metformin or sulphonylurea or thiazolidinedione in certain circumstances.

Conclusion:  Sitagliptin from this initial data appears to be a safe, weight neutral and effective anti-diabetic agent.