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Posted by on Aug 1, 2015 in Diabetes mellitus | 15 comments

In a nutshell

This study compared the effectiveness and safety of two drugs in the treatment of type 2 diabetes patients with kidney disease.

Some background

Type 2 diabetes (T2D) is characterized by elevated blood glucose. Treatment involves lowering blood glucose. HbA1c (average blood glucose over 3 months) and fasting plasma glucose (FPG, glucose levels after several hours without food) can be measured to estimate the effectiveness of drugs. 

T2D patients are more susceptible to kidney disease. Treatment of T2D patients with kidney disease is more complex. This group is at a higher risk of developing hypoglycemia (low blood sugar) as a side effect of treatment.

Dipeptidyl peptidase-4 (DPP-4) inhibitors are drugs used to treat diabetes. Examples include vildagliptin (Xiliarx, Jalra, Galvus) and sitagliptin (Januvia).  DPP-4 inhibitors are approved for treatment of T2D patients with kidney disease. However, few studies have compared different DPP-4 inhibitors.

Methods & findings

This study compared the effectiveness and safety of vildagliptin and sitagliptin in patients with T2D and severe kidney disease. 117 patients took part in the study. 64 patients were treated with vildagliptin and 53 were treated with sitagliptin. HbA1c and FPG were tested at the beginning of the study and after 24 weeks. Side effects related to drug treatment were recorded.

There was no significant difference in HbA1c reduction between the 2 groups. HbA1c was reduced by  0.54% in patients treated with vildagliptin and 0.56% in patients treated with sitagliptin. Similarly, there was no significant difference in FPG change between the two groups. FPG decreased by 0.47 mmol/l with vildagliptin. FPG increased by 0.16 mmol/l in patients taking sitagliptin.

Occurrence of more than one episode of hypoglycemia was similar in both groups, and occured in 16% of vildagliptin patients and 15% of sitagliptin patients. 51% of sitagliptin patients and 33% of vildagliptin patients experienced symptoms suggestive of hypoglycemia, such as dizziness and fatigue.

The bottom line

This study concluded that vildagliptin and sitagliptin are both similarly effective and safe treatments for patients with T2D and kidney disease. 

The fine print

This study was conducted by Novartis, the producer of vildagliptin.

What’s next?

Consult your doctor if you are concerned about any of the side effects of vildagliptin or sitagliptin.

Published By :

Diabetologia

Date :

Jun 12, 2015

Original Title :

Comparison of vildagliptin and sitagliptin in patients with type 2 diabetes and severe renal impairment: a randomised clinical trial.

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