PMID- 22071236
OWN - NLM
STAT- MEDLINE
DCOM- 20120313
LR  - 20220331
IS  - 1879-114X (Electronic)
IS  - 0149-2918 (Linking)
VI  - 33
IP  - 11
DP  - 2011 Nov
TI  - Tolerability of dipeptidyl peptidase-4 inhibitors: a review.
PG  - 1609-29
LID - 10.1016/j.clinthera.2011.09.028 [doi]
AB  - BACKGROUND: Oral glucose-lowering agents are used to treat patients with type 2 
      diabetes mellitus (T2DM). Most patients require multiple agents to maintain 
      glycemic targets. Dipeptidyl peptidase-4 (DPP-4) inhibitors are administered as 
      monotherapy and in combination therapy for the treatment of T2DM. OBJECTIVE: The 
      aim of this article was to provide a thorough review of published tolerability 
      data on 5 DPP-4 inhibitors. METHODS: PubMed and Web of Science were searched for 
      English-language clinical trials published from January 2000 to June 2001, using 
      the following key words: dipeptidyl peptidase-4 inhibitor, vildagliptin, 
      alogliptin, sitagliptin, saxagliptin, linagliptin, safety, tolerability, 
      efficacy, effect, AE, and adverse effect. Studies were considered for inclusion 
      if they were randomized, double-blind trials performed in patients >/=18 years of 
      age with T2DM and with a hemoglobin A(1c) of >/=6.5%; included >/=1 arm that received 
      monotherapy with DPP-4; and reported adverse events (AEs). Studies in patients 
      with a history of type 1 or secondary forms of diabetes, significant diabetic 
      complications or cardiovascular disease within the 6 months before the start of 
      the study, hepatic disease or abnormalities, and/or renal abnormalities were 
      excluded. RESULTS: A total of 45 clinical trials, 5 pharmacokinetic studies, and 
      28 meta-analyses or reviews were included. The duration of studies ranged from 7 
      days to 104 weeks. The most commonly reported AEs were nasopharyngitis, upper 
      respiratory infections, all-cause infections, headache, gastrointestinal 
      symptoms, and musculoskeletal pain. Based on the findings from the studies, the 
      DPP-4 inhibitors had minimal impact on weight and were not associated with an 
      increased risk for hypoglycemia relative to placebo. Rates of nasopharyngitis 
      were higher with the DDP-4 inhibitors than with placebo. Pancreatitis was 
      reported at lower rates with the DPP-4 inhibitors compared with other oral 
      antihyperglycemic agents. Cardiovascular events were limited, and postmarketing 
      studies are ongoing. CONCLUSIONS: The tolerability of DPP-4 inhibitors is 
      supported by published clinical trials. The rates of weight gain, 
      gastrointestinal AEs, and hypoglycemia were minimal with the DPP-4 inhibitors 
      studied.
CI  - Copyright (c) 2011 Elsevier HS Journals, Inc. All rights reserved.
FAU - Richard, Kathleen R
AU  - Richard KR
AD  - Wake Forest School of Medicine, Winston-Salem, North Carolina.
FAU - Shelburne, Jamie S
AU  - Shelburne JS
FAU - Kirk, Julienne K
AU  - Kirk JK
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20111108
PL  - United States
TA  - Clin Ther
JT  - Clinical therapeutics
JID - 7706726
RN  - 0 (Dipeptidyl-Peptidase IV Inhibitors)
RN  - 0 (Placebos)
SB  - IM
MH  - Diabetes Mellitus, Type 2/*drug therapy
MH  - Dipeptidyl-Peptidase IV Inhibitors/adverse effects/*therapeutic use
MH  - Humans
MH  - Placebos
MH  - Randomized Controlled Trials as Topic
EDAT- 2011/11/11 06:00
MHDA- 2012/03/14 06:00
CRDT- 2011/11/11 06:00
PHST- 2011/06/14 00:00 [received]
PHST- 2011/09/23 00:00 [revised]
PHST- 2011/09/23 00:00 [accepted]
PHST- 2011/11/11 06:00 [entrez]
PHST- 2011/11/11 06:00 [pubmed]
PHST- 2012/03/14 06:00 [medline]
AID - S0149-2918(11)00636-9 [pii]
AID - 10.1016/j.clinthera.2011.09.028 [doi]
PST - ppublish
SO  - Clin Ther. 2011 Nov;33(11):1609-29. doi: 10.1016/j.clinthera.2011.09.028. Epub 
      2011 Nov 8.