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Fixed-dose combination therapy for type 2 diabetes: sitagliptin plus pioglitazone.
Expert Opin Investig Drugs. 2010 Aug; 19(8):1017-25.EO

Abstract

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.

Authors+Show Affiliations

Aston University, Department of Life and Health Sciences, Birmingham, UK. c.j.bailey@aston.ac.ukNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

20629618

Citation

Bailey, Clifford J., et al. "Fixed-dose Combination Therapy for Type 2 Diabetes: Sitagliptin Plus Pioglitazone." Expert Opinion On Investigational Drugs, vol. 19, no. 8, 2010, pp. 1017-25.
Bailey CJ, Green BD, Flatt PR. Fixed-dose combination therapy for type 2 diabetes: sitagliptin plus pioglitazone. Expert Opin Investig Drugs. 2010;19(8):1017-25.
Bailey, C. J., Green, B. D., & Flatt, P. R. (2010). Fixed-dose combination therapy for type 2 diabetes: sitagliptin plus pioglitazone. Expert Opinion On Investigational Drugs, 19(8), 1017-25. https://doi.org/10.1517/13543784.2010.505235
Bailey CJ, Green BD, Flatt PR. Fixed-dose Combination Therapy for Type 2 Diabetes: Sitagliptin Plus Pioglitazone. Expert Opin Investig Drugs. 2010;19(8):1017-25. PubMed PMID: 20629618.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fixed-dose combination therapy for type 2 diabetes: sitagliptin plus pioglitazone. AU - Bailey,Clifford J, AU - Green,Brian D, AU - Flatt,Peter R, PY - 2010/7/16/entrez PY - 2010/7/16/pubmed PY - 2010/10/26/medline SP - 1017 EP - 25 JF - Expert opinion on investigational drugs JO - Expert Opin Investig Drugs VL - 19 IS - 8 N2 - 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. SN - 1744-7658 UR - https://www.unboundmedicine.com/medline/citation/20629618/Fixed_dose_combination_therapy_for_type_2_diabetes:_sitagliptin_plus_pioglitazone_ DB - PRIME DP - Unbound Medicine ER -