PMID- 22736406
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20121002
LR  - 20211021
IS  - 1869-6961 (Electronic)
IS  - 1869-6953 (Print)
IS  - 1869-6961 (Linking)
VI  - 3
IP  - 1
DP  - 2012 Nov
TI  - Impact of insulin resistance, body mass index, disease duration, and duration of 
      metformin use on the efficacy of vildagliptin.
PG  - 8
LID - 10.1007/s13300-012-0008-5 [doi]
LID - 8
AB  - INTRODUCTION: The optimal stage for dipeptidyl peptidase-4 (DPP-4) inhibitor 
      therapy in the course of type 2 diabetes mellitus (T2DM) is still under 
      discussion, with often a perception that treatment with these agents may be less 
      beneficial with increasing disease progression, due to loss of beta-cell 
      function, and with increasing insulin resistance (IR), where beta-cell function 
      is less prominent. This work, therefore, aimed to assess the impact of such 
      factors on the efficacy of the DPP-4 inhibitor, vildagliptin, in add-on therapy 
      to metformin. METHODS: A pooled analysis of 24-week efficacy data of vildagliptin 
      50 mg twice daily (b.i.d.) (n = 2,478) from four add-on to metformin studies was 
      performed. Analyses for changes in hemoglobin A(1c) (HbA(1c)) were stratified 
      according to baseline IR stage (homeostasis model assessment [Homa IR] <5, >/=5), 
      body mass index (BMI) (<27, >/=27 to <30, >/=30 kg/m(2)), T2DM duration 
      (0 to <1, >/=1 to <5, >/=5 years), and duration of metformin use 
      (0 to <1, >/=1 to <5, >/=5 years). Data from patients treated with sulfonylureas 
      (SUs) (n = 2,010) in the pooled studies are provided as reference. RESULTS: 
      Patients in the vildagliptin and SU groups had mean age, HbA(1c), BMI, Homa IR, 
      duration of T2DM and metformin use of 58 years, 7.7%, 32 kg/m(2), 4.3, 5.9 years 
      and 3.0 years, respectively. Reductions from baseline in HbA(1c) with 
      vildagliptin were very similar across Homa IR (mean 2.8 and 8.6), BMI (mean 24.9, 
      28.5, and 35.3 kg/m(2)), T2DM duration (mean 0.6, 2.9, and 9.7 years), and 
      duration of metformin use (mean 0.6, 2.6, and 7.9 years) categories, showing 
      significant drops in HbA(1c) of approximately -0.7% (baseline 7.7%). The results 
      in patients receiving SUs were comparable to those seen in the vildagliptin 
      group. CONCLUSION: Vildagliptin add-on therapy to metformin was efficacious 
      independent of IR stage and BMI, as well as disease duration and duration of 
      prior metformin use, indicating that, contrary to a not uncommon perception, more 
      obese patients and patients with long-standing T2DM can benefit from treatment 
      with the DPP-4 inhibitor, vildagliptin.
FAU - Schweizer, Anja
AU  - Schweizer A
AD  - Novartis Pharma AG, Postfach, 4002, Basel, Switzerland, 
      anja.schweizer@novartis.com.
FAU - Dejager, Sylvie
AU  - Dejager S
FAU - Foley, James E
AU  - Foley JE
LA  - eng
PT  - Journal Article
DEP - 20120627
PL  - United States
TA  - Diabetes Ther
JT  - Diabetes therapy : research, treatment and education of diabetes and related 
      disorders
JID - 101539025
PMC - PMC3508106
EDAT- 2012/06/28 06:00
MHDA- 2012/06/28 06:01
PMCR- 2012/06/27
CRDT- 2012/06/28 06:00
PHST- 2012/05/03 00:00 [received]
PHST- 2012/06/28 06:00 [entrez]
PHST- 2012/06/28 06:00 [pubmed]
PHST- 2012/06/28 06:01 [medline]
PHST- 2012/06/27 00:00 [pmc-release]
AID - 8 [pii]
AID - 10.1007/s13300-012-0008-5 [doi]
PST - ppublish
SO  - Diabetes Ther. 2012 Nov;3(1):8. doi: 10.1007/s13300-012-0008-5. Epub 2012 Jun 27.