Abstract
Aims
This study assessed the independent predictors of the hemoglobin A1c (HbA1c)-lowering effect of vildagliptin in Japanese patients with type 2 diabetes.
Materials and methods
The data of a total of 155 patients with type 2 diabetes who had been taking vildagliptin 50 or 100 mg once or twice daily for inadequate glycemic control for at least 12 weeks regardless of oral hypoglycemic agents (OHAs) were retrieved from medical records. Spearman’s rank correlation coefficient method was applied to determine the correlations between sets of two independent continuous variables. Multiple linear regression analysis was used to search for independent predictors of the reduction in HbA1c levels after 12 weeks of vildagliptin treatment (ΔHbA1c).
Results
Among all subjects, ΔHbA1c was positively correlated with baseline HbA1c (r = 0.549, P < 0.0001). Multiple linear regression analysis using baseline variables among all patients also revealed that the independent factors contributing to ΔHbA1c were prescribing method (drug naïve or add-on vs. switch from other OHAs; P < 0.0001) and baseline HbA1c (P < 0.0001), without being significantly influenced by body mass index, diabetes duration, or age.
Conclusions
Our analysis provides evidence that baseline HbA1c and prescribing method contribute to the HbA1c-lowering effect of vildagliptin in Japanese patients with type 2 diabetes. Long-term analysis of a larger population is warranted to confirm these findings.
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References
Drucker DJ, Nauck MA. GLP-1R agonists (incretin mimetics) and DPP-4 inhibitors (incretin enhancers) for the treatment of type 2 diabetes. Lancet. 2006;368:1696–705.
Bando Y, Kanehara H, Aoki K, et al. Obesity may attenuate the HbA1c-lowering effect of sitagliptin in Japanese type 2 diabetic patients. J Diabetes Invest. 2012;. doi:10.1111/j.2040-1124.2011.00156.x.
Ristic S, Byiers S, Foley J, et al. Improved glycaemic control with dipeptidyl peptidase-4 inhibition in patients with type 2 diabetes: vildagliptin (LAF237) dose response. Diabetes Obes Metab. 2005;7:692–8.
Ahrén B, Schweizer A, Dejager S, et al. Mechanisms of action of the dipeptidyl peptidase-4 inhibitor vildagliptin in humans. Diabetes Obes Metab. 2011;13:775–83.
Vanita RA, Robert RH, Jenny H, et al. Efficacy of GLP-1 receptor agonists and DPP-4 inhibitors: meta-analysis and systematic review. Clin Ther. 2012;34:1247–58.
Tominaga M, Makino H, Yoshino G, et al. Japanese standard reference material for JDS Lot 2 haemoglobin A1c. I: comparison of Japan Diabetes Society-assigned values to those obtained by the Japanese and USA domestic standardization programmes and by the International Federation of Clinical Chemistry reference laboratories. Ann Clin Biochem. 2005;42:41–6.
Seino Y, Nanjo K, Tajima N, et al. Report of the committee on the classification and diagnostic criteria of diabetes mellitus. J Diabetes Invest. 2010;1:212–28.
Kashiwagi A, Kasuga M, Araki E, et al. International clinical harmonization of glycated hemoglobin in Japan: from Japan Diabetes Society to National Glycohemoglobin Standardization Program values. J Diabetes Invest. 2012;3:39–40.
Matsuo S, Imai E, Horio M, et al. Revised equations for estimated GFR from serum creatinine in Japan. Am J Kidney Dis. 2009;53:982–92.
Coresh J, Astor BC, Greene T, et al. Prevalence of chronic kidney disease and decreased kidney function in the adult US population. Am J Kidney Dis. 2003;41:1–12.
World Medical Association. Declaration of Helsinki. Recommendations guiding physicians in biomedical research involving human subjects. J Am Med Assoc. 1997;277:925–6.
Okayama N, Imaeda K, Kato T, et al. Predictive clinical characteristics for the efficacy of vildagliptin monotherapy in Japanese patients with type 2 diabetes mellitus: multicenter study. Diabetes Int. 2013;4:179–85.
Chang JS, Shin J, Kim HS, et al. Predictive clinical parameters and glycemic efficacy of vildagliptin treatment in Korean subjects with type 2 diabetes. Diabetes Metab J. 2013;37:72–80.
Senmaru T, Fukui M, Kobayashi K, et al. Dipeptidyl peptidase IV inhibitor is effective in patients with type 2 diabetes with high serum eicosapentaenoic acid concentrations. J Diabetes Invest. 2012;. doi:10.1111/j.2040-1124.2012.00220.x.
Maeda H, Kubota A, Tanaka Y, Terauchi Y, Matsuba I, ASSET-K Study group. The safety, efficacy and predictors for HbA1c reduction of sitagliptin in the treatment of Japanese type 2 diabetes. Diabetes Res Clin Pract. 2012;95:e20–2.
Kim SA, Shim WH, Lee EH, Lee YM, et al. Predictive clinical parameters for the therapeutic efficacy of sitagliptin in Korean type 2 diabetes mellitus. Diabetes Metab J. 2011;35:159–65.
Herman GA, Bergman A, Stevens C, et al. Effect of single oral doses of sitagliptin, a dipeptidyl peptidase-4 inhibitor, on incretin and plasma glucose levels after an oral glucose tolerance test in patients with type 2 diabetes. J Clin Endocrinol Metab. 2006;91:4612–9.
Mari A, Sallas WM, He YL, et al. Vildagliptin, a dipeptidyl peptidase-IV inhibitor, improves model assessed beta-cell function in patients with type 2 diabetes. J Clin Endocrinol Metab. 2005;90:4888–94.
Marfella R, Barbieri M, Grella R, et al. Effects of vildagliptin twice daily vs. sitagliptin once daily on 24-hour acute glucose fluctuations. J Diabetes Complicat. 2010;24:79–83.
Signorovitch JE, Wu EQ, Swallow E, et al. Comparative efficacy of vildagliptin and sitagliptin in Japanese patients with type 2 diabetes mellitus. Clin Drug Investig. 2011;31:665–74.
Lamers D, Famulla S, Wronkowitz N, et al. Dipeptidyl peptidase 4 is a novel adipokine potentially linking obesity to the metabolic syndrome. Diabetes. 2011;60:1917–25.
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The authors declare that they have no conflict of interest. This work was not supported by any grant.
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Bando, Y., Yamada, M., Aoki, K. et al. Predictive clinical parameters for the hemoglobin A1c-lowering effect of vildagliptin in Japanese patients with type 2 diabetes. Diabetol Int 5, 229–233 (2014). https://doi.org/10.1007/s13340-014-0161-3
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DOI: https://doi.org/10.1007/s13340-014-0161-3