| Fixed-dose combination therapy for type 2 diabetes: sitagliptin plus pioglitazone. | |
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MedLine Citation:
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PMID: 20629618 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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IMPORTANCE OF THE FIELD: Type 2 diabetes is typically associated with insulin resistance and dysfunction of insulin-secreting pancreatic beta-cells. Addressing these defects often requires therapy with a combination of differently acting antidiabetic agents. A potential novel combination in development brings together the dipeptidyl peptidase-4 (DPP-4) inhibitor sitagliptin with the thiazolidinedione pioglitazone into a fixed-dose single-tablet combination. The former component acts mainly to increase prandial insulin secretion; the latter improves insulin sensitivity. AREAS COVERED IN THIS REVIEW: To date, clinical trials conducted in type 2 diabetes patients have used combinations of sitagliptin (100 mg/day) and pioglitazone (30 - 45 mg/day) as separate tablets. These trials have shown that the combinations offer additive efficacy in reducing blood glucose when given as initial antidiabetic therapy and as add-on therapy when pioglitazone alone fails to maintain glycemic control. WHAT THE READER WILL GAIN: Initial therapy with a combination of sitagliptin (100 mg/day) and pioglitazone (30 mg/day) reduced HbA1c by > 2% starting from a baseline > 9%. Adding sitagliptin (50 - 100 mg/day) to patients inadequately controlled on pioglitazone reduced HbA1c by 0.7 - 1.4% from a baseline of 8 - 8.5%. The combination did not increase the risk of hypoglycemia and produced similar or slightly more weight gain than pioglitazone alone when introduced as initial antidiabetic therapy. TAKE HOME MESSAGE: The combination of sitagliptin and pioglitazone was well tolerated in these trials, and would appear to be suited to a fixed-dose single-tablet combination for once-daily administration. |
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Authors:
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Clifford J Bailey; Brian D Green; Peter R Flatt |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Expert opinion on investigational drugs Volume: 19 ISSN: 1744-7658 ISO Abbreviation: Expert Opin Investig Drugs Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-07-15 Completed Date: 2010-10-25 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9434197 Medline TA: Expert Opin Investig Drugs Country: England |
Other Details:
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Languages: eng Pagination: 1017-25 Citation Subset: IM |
Affiliation:
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Aston University, Department of Life and Health Sciences, Birmingham, UK. c.j.bailey@aston.ac.uk |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Animals Clinical Trials as Topic Diabetes Mellitus, Type 2 / drug therapy* Dipeptidyl-Peptidase IV Inhibitors / administration & dosage*, adverse effects, pharmacology, therapeutic use Drug Therapy, Combination Female Humans Hypoglycemia / prevention & control Hypoglycemic Agents / administration & dosage*, adverse effects, pharmacology, therapeutic use Insulin Resistance Male Pyrazines / administration & dosage*, adverse effects, pharmacology, therapeutic use Thiazolidinediones / administration & dosage*, adverse effects, metabolism, pharmacology, therapeutic use Triazoles / administration & dosage*, adverse effects, pharmacology, therapeutic use |
| Chemical | |
Reg. No./Substance:
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0/Dipeptidyl-Peptidase IV Inhibitors; 0/Hypoglycemic Agents; 0/Pyrazines; 0/Thiazolidinediones; 0/Triazoles; 0/sitagliptin; 111025-46-8/pioglitazone |
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