PMID- 19065993
OWN - NLM
STAT- MEDLINE
DCOM- 20090107
LR  - 20221207
IS  - 1176-6344 (Print)
IS  - 1178-2048 (Electronic)
IS  - 1176-6344 (Linking)
VI  - 4
IP  - 4
DP  - 2008
TI  - Emerging role of dipeptidyl peptidase-4 inhibitors in the management of type 2 
      diabetes.
PG  - 753-68
AB  - BACKGROUND: In type 2 diabetes mellitus (T2DM) there is a progressive loss of 
      beta-cell function. One new approach yielding promising results is the use of the 
      orally active dipeptidyl peptidase-4 (DPP-4) inhibitors. However, every new 
      compound for T2DM has to prove long-term safety especially on cardiovascular 
      outcomes. OBJECTIVES: Systematic review and meta-analysis of the effects of 
      sitagliptin and vildagliptin therapy on main efficacy parameters and safety. 
      SELECTION CRITERIA, DATA COLLECTION, AND ANALYSIS: Randomized controlled clinical 
      studies of at least 12 weeks' duration in T2DM. RESULTS: DPP-4 inhibitors versus 
      placebo showed glycosylated hemoglobin A1c (A1c) improvements of 0.7% versus 
      placebo but not compared to monotherapy with other hypoglycemic agents (0.3% in 
      favor of controls). The overall risk profile of DPP-4 inhibitors was low, however 
      a 34% relative risk increase (95% confidence interval 10% to 64%, P = 0.004) was 
      noted for all-cause infection associated with sitagliptin use. No data on immune 
      function, health-related quality of life and diabetic complications could be 
      extracted. CONCLUSIONS: DPP-4 inhibitors have some theoretical advantages over 
      existing therapies with oral antidiabetic compounds but should currently be 
      restricted to individual patients. Long-term data on cardiovascular outcomes and 
      safety are needed before widespread use of these new agents.
FAU - Richter, Bernd
AU  - Richter B
AD  - Cochrane Metabolic and Endocrine Disorders Group, Department of General Practice, 
      Heinrich-Heine University Duesseldorf, Duesseldorf, Germany. 
      richterb@uni-duesseldorf.de
FAU - Bandeira-Echtler, Elizabeth
AU  - Bandeira-Echtler E
FAU - Bergerhoff, Karla
AU  - Bergerhoff K
FAU - Lerch, Christian
AU  - Lerch C
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
PL  - New Zealand
TA  - Vasc Health Risk Manag
JT  - Vascular health and risk management
JID - 101273479
RN  - 0 (Dipeptidyl-Peptidase IV Inhibitors)
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Nitriles)
RN  - 0 (Pyrazines)
RN  - 0 (Pyrrolidines)
RN  - 0 (Triazoles)
RN  - 0 (hemoglobin A1c protein, human)
RN  - EC 3.4.14.5 (DPP4 protein, human)
RN  - EC 3.4.14.5 (Dipeptidyl Peptidase 4)
RN  - I6B4B2U96P (Vildagliptin)
RN  - PJY633525U (Adamantane)
RN  - TS63EW8X6F (Sitagliptin Phosphate)
SB  - IM
MH  - Adamantane/adverse effects/*analogs & derivatives/pharmacokinetics/therapeutic 
      use
MH  - Diabetes Mellitus, Type 2/*drug therapy/enzymology
MH  - Dipeptidyl Peptidase 4/metabolism
MH  - *Dipeptidyl-Peptidase IV Inhibitors/adverse effects/pharmacokinetics/*therapeutic 
      use
MH  - Glycated Hemoglobin/metabolism
MH  - Humans
MH  - Hypoglycemic Agents/adverse effects/pharmacokinetics/*therapeutic use
MH  - Nitriles/adverse effects/pharmacokinetics/*therapeutic use
MH  - Pyrazines/adverse effects/pharmacokinetics/*therapeutic use
MH  - Pyrrolidines/adverse effects/pharmacokinetics/*therapeutic use
MH  - Sitagliptin Phosphate
MH  - Treatment Outcome
MH  - Triazoles/adverse effects/pharmacokinetics/*therapeutic use
MH  - Vildagliptin
PMC - PMC2597770
EDAT- 2008/12/11 09:00
MHDA- 2009/01/08 09:00
PMCR- 2008/12/01
CRDT- 2008/12/11 09:00
PHST- 2008/12/11 09:00 [pubmed]
PHST- 2009/01/08 09:00 [medline]
PHST- 2008/12/11 09:00 [entrez]
PHST- 2008/12/01 00:00 [pmc-release]
AID - vhrm-4-0753 [pii]
AID - 10.2147/vhrm.s1707 [doi]
PST - ppublish
SO  - Vasc Health Risk Manag. 2008;4(4):753-68. doi: 10.2147/vhrm.s1707.