Kawasaki E, Nakano Y, Fukuyama T, Uchida A, Sagara Y, Tamai H, Tojikubo M, Hiromatsu Y, Koga N. Efficacy of omarigliptin, once-weekly dipeptidyl peptidase-4 inhibitor, in patients with type 2 diabetes. World J Diabetes 2021; 12(12): 2087-2095 [PMID: 35047122 DOI: 10.4239/wjd.v12.i12.2087]
Corresponding Author of This Article
Eiji Kawasaki, MD, PhD, Director, Department of Diabetes and Endocrinology, Shin-Koga Hospital, 120 Tenjin-cho, Kurume 830-8577, Japan. e-kawasaki@tenjinkai.or.jp
Research Domain of This Article
Endocrinology & Metabolism
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Eiji Kawasaki, Yuko Nakano, Takahiro Fukuyama, Aira Uchida, Yoko Sagara, Hidekazu Tamai, Masayuki Tojikubo, Yuji Hiromatsu, Nobuhiko Koga, Department of Diabetes and Endocrinology, Shin-Koga Hospital, Kurume 830-8577, Japan
Author contributions: Kawasaki E designed and performed the research and wrote the manuscript; Kawasaki E contributed to the conception, design of the work, analysis, and interpretation of data for the work; Nakano Y contributed to the analysis and interpretation of data for the work; Fukuyama T, Uchida A, Sagara Y, Tamai H, Tojikubo M, Hiromatsu Y, and Koga N contributed to the interpretation of data for the work; All authors have read and approved the final manuscript.
Institutional review board statement: This study’s protocol has been reviewed and approved by the ethics committee of Shin-Koga hospital.
Informed consent statement: To collected the retrospective data patients did not provide their verbal or written informed consent to join the study but were instead allowed to refuse participation according to the Japanese Ethical Guidelines for Medical and Health Research Involving Human Subjects and the local Institutional Review Board Approval due to its retrospective nature. As for the continuous glucose monitoring study, all patients provided informed written consent prior to enrollment.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Eiji Kawasaki, MD, PhD, Director, Department of Diabetes and Endocrinology, Shin-Koga Hospital, 120 Tenjin-cho, Kurume 830-8577, Japan. e-kawasaki@tenjinkai.or.jp
Received: February 3, 2021 Peer-review started: February 3, 2021 First decision: August 19, 2021 Revised: September 1, 2021 Accepted: December 8, 2021 Article in press: December 8, 2021 Published online: December 15, 2021
ARTICLE HIGHLIGHTS
Research background
Dipeptidyl peptidase-4 inhibitors (DPP-4is) have become standard medications for glycemic control in patients with type 2 diabetes (T2D). Despite the high frequency of switching from various daily DPP-4is to once-weekly DPP-4is in actual clinical practice, data regarding its efficacy in patients with T2D after switching are limited.
Research motivation
Compound-specific effects can be present and influence the efficacy of daily DPP-4is in patients with T2D.
Research objectives
The authors analyzed the efficacy of omarigliptin, one of several once-weekly DPP-4is, in Japanese patients with T2D who had previously received treatment with other glucose-lowering agents.
Research methods
The 49 patients in this study were divided into four groups defined as either add-on or switched from daily DPP-4is (linagliptin, sitagliptin, and vildagliptin), and the clinical parameters among these groups were assessed and compared during a 3-mo follow-up. Additionally, glycemic variability measured by continuous glucose monitoring was also assessed in the switched groups.
Research results
The glycemic control saw significant improvement in the add-on group, while the switched from vildagliptin to omarigliptin group experienced significant worsening. Multivariate logistic regression analysis revealed that switching from vildagliptin to omarigliptin was independently associated with worsening glycemic control (P = 0.0013). However, the mean of daily difference significantly improved when the patient was switched from either linagliptin or sitagliptin to omarigliptin but significantly worsened when patients were switched from vildagliptin.
Research conclusions
Administering omarigliptin as add-on therapy or switching from sitagliptin and linagliptin, but not vildagliptin, provides more effective glycemic control. These results should help in decision-making regarding the selection and use of DPP-4is in patients with T2D.
Research perspectives
To investigate the efficacy and safety of all types of daily DPP-4is, a prospective study using a larger cohort and inclusive of a control group should be conducted in the future.
