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Evaluation of the potential for pharmacokinetic and pharmacodynamic interactions between dutogliptin, a novel DPP4 inhibitor, and metformin, in type 2 diabetic patients.
Curr Med Res Opin. 2010 Aug; 26(8):2003-10.CM

Abstract

OBJECTIVE

Dutogliptin is a novel, orally available, potent, and selective DPP4 inhibitor that improves glycemic control in type 2 diabetic patients. The objective of this study was to evaluate the potential pharmacokinetic and pharmacodynamic interactions, as well as the tolerability, of dutogliptin and metformin alone and in combination in type 2 diabetic patients.

METHODS

This was a single-center, randomized, open-label, 3-way, crossover study in type 2 diabetic patients. All patients received three treatment regimens, each of 5 days duration in order to reach steady state: 400 mg once daily of dutogliptin (the anticipated clinical dose); 1000 mg metformin twice daily (maximum effective clinical dose); and concomitant administration of 400 mg dutogliptin once daily and 1000 mg metformin twice daily.

RESULTS

Co-administration of dutogliptin and metformin did not alter the pharmacokinetics of either agent. The geometric mean ratio, GMR (dutogliptin + metformin/dutogliptin) of the area under the plasma concentration-time curve (AUC(0-24h)) at steady state was 0.91 (90% CI: 0.79-1.06; p = 0.29); the GMR of the maximum plasma concentrations (C(max)) was 0.95 (90% CI: 0.76-1.19; p = 0.70); the time to maximum plasma concentrations (T(max)) was essentially the same for dutogliptin with or without metformin. The GMR (dutogliptin + metformin/metformin) of AUC(0-12h) at steady state was 0.99 (90% CI: 0.84-1.17; p = 0.93); the GMR of C(max) was 0.91 (90% CI: 0.79-1.04; p = 0.18); T(max) was comparable for metformin with or without dutogliptin. Metformin added to dutogliptin had no effect on plasma DPP4 inhibition. All three treatment regimens were well tolerated.

CONCLUSIONS

In this small, multiple dose study, the steady state pharmacokinetics of either dutogliptin or metformin were not altered by co-administration of the two agents. Dutogliptin and metformin were well tolerated either alone or in combination and co-administered metformin did not alter the ex vivo DPP4 inhibition by dutogliptin. There is no need to consider pharmacokinetic and pharmacodynamic interactions when determining the dosage of either agent for co-administration. A phase 3 clinical trial is underway to provide more definitive data on the safety and efficacy of dutogliptin administered on a background of metformin treatment.

Authors+Show Affiliations

Pharmacokinetics, Dynamics & Metabolism, Phenomix Corporation, San Diego, CA 92121, USA. Jack.Li@phenomixcorp.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial, Phase I
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20583949

Citation

Li, Jianke, et al. "Evaluation of the Potential for Pharmacokinetic and Pharmacodynamic Interactions Between Dutogliptin, a Novel DPP4 Inhibitor, and Metformin, in Type 2 Diabetic Patients." Current Medical Research and Opinion, vol. 26, no. 8, 2010, pp. 2003-10.
Li J, Klemm K, O'Farrell AM, et al. Evaluation of the potential for pharmacokinetic and pharmacodynamic interactions between dutogliptin, a novel DPP4 inhibitor, and metformin, in type 2 diabetic patients. Curr Med Res Opin. 2010;26(8):2003-10.
Li, J., Klemm, K., O'Farrell, A. M., Guler, H. P., Cherrington, J. M., Schwartz, S., & Boyea, T. (2010). Evaluation of the potential for pharmacokinetic and pharmacodynamic interactions between dutogliptin, a novel DPP4 inhibitor, and metformin, in type 2 diabetic patients. Current Medical Research and Opinion, 26(8), 2003-10. https://doi.org/10.1185/03007995.2010.491266
Li J, et al. Evaluation of the Potential for Pharmacokinetic and Pharmacodynamic Interactions Between Dutogliptin, a Novel DPP4 Inhibitor, and Metformin, in Type 2 Diabetic Patients. Curr Med Res Opin. 2010;26(8):2003-10. PubMed PMID: 20583949.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evaluation of the potential for pharmacokinetic and pharmacodynamic interactions between dutogliptin, a novel DPP4 inhibitor, and metformin, in type 2 diabetic patients. AU - Li,Jianke, AU - Klemm,Kirsti, AU - O'Farrell,A Marie, AU - Guler,Hans-Peter, AU - Cherrington,Julie M, AU - Schwartz,Sherwyn, AU - Boyea,Teresa, PY - 2010/6/30/entrez PY - 2010/6/30/pubmed PY - 2010/9/21/medline SP - 2003 EP - 10 JF - Current medical research and opinion JO - Curr Med Res Opin VL - 26 IS - 8 N2 - OBJECTIVE: Dutogliptin is a novel, orally available, potent, and selective DPP4 inhibitor that improves glycemic control in type 2 diabetic patients. The objective of this study was to evaluate the potential pharmacokinetic and pharmacodynamic interactions, as well as the tolerability, of dutogliptin and metformin alone and in combination in type 2 diabetic patients. METHODS: This was a single-center, randomized, open-label, 3-way, crossover study in type 2 diabetic patients. All patients received three treatment regimens, each of 5 days duration in order to reach steady state: 400 mg once daily of dutogliptin (the anticipated clinical dose); 1000 mg metformin twice daily (maximum effective clinical dose); and concomitant administration of 400 mg dutogliptin once daily and 1000 mg metformin twice daily. RESULTS: Co-administration of dutogliptin and metformin did not alter the pharmacokinetics of either agent. The geometric mean ratio, GMR (dutogliptin + metformin/dutogliptin) of the area under the plasma concentration-time curve (AUC(0-24h)) at steady state was 0.91 (90% CI: 0.79-1.06; p = 0.29); the GMR of the maximum plasma concentrations (C(max)) was 0.95 (90% CI: 0.76-1.19; p = 0.70); the time to maximum plasma concentrations (T(max)) was essentially the same for dutogliptin with or without metformin. The GMR (dutogliptin + metformin/metformin) of AUC(0-12h) at steady state was 0.99 (90% CI: 0.84-1.17; p = 0.93); the GMR of C(max) was 0.91 (90% CI: 0.79-1.04; p = 0.18); T(max) was comparable for metformin with or without dutogliptin. Metformin added to dutogliptin had no effect on plasma DPP4 inhibition. All three treatment regimens were well tolerated. CONCLUSIONS: In this small, multiple dose study, the steady state pharmacokinetics of either dutogliptin or metformin were not altered by co-administration of the two agents. Dutogliptin and metformin were well tolerated either alone or in combination and co-administered metformin did not alter the ex vivo DPP4 inhibition by dutogliptin. There is no need to consider pharmacokinetic and pharmacodynamic interactions when determining the dosage of either agent for co-administration. A phase 3 clinical trial is underway to provide more definitive data on the safety and efficacy of dutogliptin administered on a background of metformin treatment. SN - 1473-4877 UR - https://www.unboundmedicine.com/medline/citation/20583949/Evaluation_of_the_potential_for_pharmacokinetic_and_pharmacodynamic_interactions_between_dutogliptin_a_novel_DPP4_inhibitor_and_metformin_in_type_2_diabetic_patients_ L2 - https://www.tandfonline.com/doi/full/10.1185/03007995.2010.491266 DB - PRIME DP - Unbound Medicine ER -