Efficacy of vildagliptin and sitagliptin in lowering fasting plasma glucose: Results of a randomized controlled trial - 13/11/14

Doi : 10.1016/j.diabet.2014.07.004

R. Göke ^a, P. Eschenbach ^b, E.D. Dütting ^b,^⁎
^a Diabetes Center, Marburg-Cappel, Germany
^b Novartis Pharma GmbH, Nuremberg, Germany

^⁎Corresponding author. Novartis Pharma GmbH, Roonstr. 25, 90429 Nuremberg, Germany. Tel.: +49 911 273 12664; fax: +49 911 273 15664.

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Abstract

Aim

This study compared the efficacy of vildagliptin and sitagliptin in lowering fasting plasma glucose (FPG) as single-pill combinations (SPCs) with metformin.

Methods

The randomized crossover, open-label, active-controlled study design assessed the FPG-lowering abilities of a vildagliptin/metformin (50/1000mg twice daily) SPC compared with a sitagliptin/metformin (50/1000mg twice daily) SPC after 2 weeks of treatment in 99 type 2 diabetes patients uncontrolled by stable metformin therapy (1000–2000mg/day).

Results

The change in FPG from baseline to day 14 was significantly greater (P<0.02, Wilcoxon) with vildagliptin [–21.9mg/dL (SD 27.0)] than with sitagliptin [–14.5mg/dL (SD 23.0)]. After 14 days of treatment, the mean FPG was 137.8mg/dL (SD 28.5) with vildagliptin and 140.1mg/dL (SD 26.5) with sitagliptin (P<0.05, Wilcoxon).

Conclusion

Both of these DPP-4 inhibitors, given as SPCs twice daily with metformin, lowered FPG after 14 days of treatment. However, vildagliptin produced a significantly greater reduction in FPG vs baseline compared with sitagliptin, which may translate into clinical relevance.

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Keywords : Type 2 diabetes mellitus, Vildagliptin, Sitagliptin, Fasting plasma glucose, Dipeptidyl peptidase inhibitors