Efficacy of omarigliptin, once-weekly dipeptidyl peptidase-4 inhibitor, in patients with type 2 diabetes

doi:10.4239/wjd.v12.i12.2087

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World Journal of Diabetes

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World J Diabetes. Dec 15, 2021; 12(12): 2087-2095
Published online Dec 15, 2021. doi: 10.4239/wjd.v12.i12.2087

Efficacy of omarigliptin, once-weekly dipeptidyl peptidase-4 inhibitor, in patients with type 2 diabetes

Eiji Kawasaki, Yuko Nakano, Takahiro Fukuyama, Aira Uchida, Yoko Sagara, Hidekazu Tamai, Masayuki Tojikubo, Yuji Hiromatsu, Nobuhiko Koga

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.

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
Processing time: 316 Days and 1.3 Hours

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.