DPP-4 inhibitors offer tolerable treatment option for patients with T2DM
Use of dipeptidyl peptidase 4 (DPP-4) inhibitors in the treatment of type 2 diabetes mellitus is associated with a lower incidence of gastrointestinal adverse events compared with glucagon-like peptide 1 (GLP-1) receptor agonists, metformin and alpha-glucosidase inhibitors (AGIs), according to a study.
Researchers conducted a systematic review and meta-analysis of 165 randomized controlled trials, involving 122,072 patients, that compared DPP-4 inhibitor–based therapies with placebo and other glucose lowering agents in T2DM. The duration of studies was at least 4 weeks.
Pooled data showed that the incidence of gastrointestinal adverse events did not increase following treatment with DPP-4 inhibitors, including alogliptin (odds ratio [OR], 0.83; 95 percent CI, 0.59 to 1.15), linagliptin (OR, 1.11; 0.92 to 1.35), saxagliptin (OR, 0.96; 0.80 to 1.15), sitagliptin (OR, 0.95; 0.64 to 1.14), teneligliptin (OR, 1.50; 0.81 to 2.77) and vildagliptin (OR, 0.80; 0.63 to 1.01), relative to placebo.
There was a significant reduction in the incidence of gastrointestinal adverse events after treatment with alogliptin (OR, 0.26; 0.15 to 0.44), linagliptin (OR, 0.43; 0.25 to 0.74), saxagliptin (OR, 0.28; 0.17 to 0.46), sitagliptin (OR, 0.24; 0.17 to 0.35) and vildagliptin (OR, 0.27; 0.18 to 0.41) compared with GLP-1 receptor agonists.
Furthermore, DPP-4 inhibitors did not increase the risk of gastrointestinal adverse events relative to metformin and α-glucosidase inhibitors, and had a similar incidence of such events compared with placebo.
The present data suggest that DPP-4 inhibitors represent a tolerable treatment option for patients with T2DM, researchers said.
“For physicians, the efficacy of the medication and adverse effects of the drug must be taken into consideration … in addition to the patient’s comorbidities and history [and] desired route of administration,” they pointed out.
Such consideration is especially important in the management of diabetic patients with gastrointestinal disease, as the gastrointestinal AEs of drugs will negatively affect health-related quality of life, researchers said.