PMID- 25633134
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20150326
LR  - 20240330
IS  - 1869-6953 (Print)
IS  - 1869-6961 (Electronic)
IS  - 1869-6961 (Linking)
VI  - 6
IP  - 1
DP  - 2015 Mar
TI  - Comparison of treatment with sitagliptin or sulfonylurea in patients with type 2 
      diabetes mellitus and mild renal impairment: a post hoc analysis of clinical 
      trials.
PG  - 29-40
LID - 10.1007/s13300-015-0098-y [doi]
AB  - INTRODUCTION: Impaired renal function is a major complication of type 2 diabetes 
      mellitus (T2DM). Mild renal impairment is present in 38% of patients with T2DM 
      and may impact choice of antihyperglycemic agent. Sulfonylureas and dipeptidyl 
      peptidase-4 (DPP-4) inhibitors are commonly used to treat hyperglycemia in 
      patients with T2DM and renal impairment. Although in general sulfonylurea use is 
      associated with an increased risk of hypoglycemia and weight gain, while DPP-4 
      inhibitor use is associated with a low risk of hypoglycemia, and is weight 
      neutral, the relative efficacy and tolerability of these agents in patients with 
      mild renal impairment has not been evaluated. METHODS: In a post hoc analysis, 
      data from 1,211 subjects with T2DM and mild renal impairment (estimated 
      glomerular filtration rates of 60 to <90 mL/min/1.73 m(2)), who completed 25 or 
      30 weeks of one of three double-blind clinical trials comparing the DPP-4 
      inhibitor sitagliptin 100 mg/day with sulfonylureas in titrated doses, were 
      pooled. The analysis compared change from baseline in glycated hemoglobin 
      (HbA1c), fasting plasma glucose (FPG), body weight, incidence of symptomatic 
      hypoglycemia and the percentages of subjects meeting a composite endpoint of 
      HbA1c decrease >0.5% without symptomatic hypoglycemia or body weight gain between 
      sitagliptin and sulfonylurea treatment groups. RESULTS: HbA1c and FPG decreased 
      similarly with sitagliptin or sulfonylurea. A lower incidence of hypoglycemia was 
      observed with sitagliptin. Body weight decreased with sitagliptin but increased 
      with sulfonylurea. A greater percentage of subjects treated with sitagliptin 
      (41.1%) than treated with sulfonylurea (16.9%) achieved the composite endpoint of 
      >0.5% HbA1c reduction with no symptomatic hypoglycemia or body weight gain. 
      CONCLUSION: In this analysis of subjects with T2DM and mild renal impairment, 
      treatment with sitagliptin provided glycemic efficacy similar to sulfonylurea, 
      with less hypoglycemia and with body weight loss compared to body weight gain 
      seen with sulfonylurea. TRIAL REGISTRATIONS: ClinicalTrials.gov #NCT00482079, 
      #NCT00094770, #NCT00701090.
FAU - Ommen, Elizabeth S
AU  - Ommen ES
AD  - Merck & Co., Inc., Whitehouse Station, NJ, USA, elizabeth.ommen@merck.com.
FAU - Xu, Lei
AU  - Xu L
FAU - O'Neill, Edward A
AU  - O'Neill EA
FAU - Goldstein, Barry J
AU  - Goldstein BJ
FAU - Kaufman, Keith D
AU  - Kaufman KD
FAU - Engel, Samuel S
AU  - Engel SS
LA  - eng
SI  - ClinicalTrials.gov/NCT00482079
SI  - ClinicalTrials.gov/NCT00094770
SI  - ClinicalTrials.gov/NCT00701090
PT  - Journal Article
DEP - 20150130
PL  - United States
TA  - Diabetes Ther
JT  - Diabetes therapy : research, treatment and education of diabetes and related 
      disorders
JID - 101539025
EIN - Diabetes Ther. 2015 Mar;6(1):97-8. PMID: 25707480
PMC - PMC4374078
EDAT- 2015/01/31 06:00
MHDA- 2015/01/31 06:01
PMCR- 2015/01/30
CRDT- 2015/01/31 06:00
PHST- 2014/11/17 00:00 [received]
PHST- 2015/01/31 06:00 [entrez]
PHST- 2015/01/31 06:00 [pubmed]
PHST- 2015/01/31 06:01 [medline]
PHST- 2015/01/30 00:00 [pmc-release]
AID - 98 [pii]
AID - 10.1007/s13300-015-0098-y [doi]
PST - ppublish
SO  - Diabetes Ther. 2015 Mar;6(1):29-40. doi: 10.1007/s13300-015-0098-y. Epub 2015 Jan 
      30.