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Treats type 2 diabetes.

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Results: 13

Efficacy of alogliptin in type 2 diabetes treatment: a meta-analysis of randomized double-blind controlled studies

BACKGROUND: Alogliptin is a new dipeptidyl peptidase (DPP-4) inhibitor, which is under investigation for treatment of type 2 diabetes either alone or in combination with other antidiabetic drugs. The aim of this meta-analysis was to assess the efficacy and tolerability of alogliptin in patients with type 2 diabetes.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Second- and Third-Line Pharmacotherapy for Type 2 Diabetes: Update [Internet]

In August 2010, the Canadian Agency for Drugs and Technologies in Health (CADTH) published an Optimal Therapy Report which assessed the clinical and cost-effectiveness of second-line therapies for patients with type 2 diabetes inadequately controlled on metformin. The results from the CADTH review indicated that there were no apparent differences in efficacy across drug classes, and that sulfonylureas were the most cost-effective treatment option. Based on these analyses, the Canadian Optimal Medication Prescribing and Utilization Service (COMPUS) Expert Review Committee (CERC) recommended that most patients requiring a second treatment after metformin should be prescribed a sulfonylurea. CADTH followed this report with a Therapeutic Review which examined the evidence for third-line treatment options for adults with type 2 diabetes inadequately controlled on metformin and a sulfonylurea. The results demonstrated that insulins (basal, biphasic, bolus), dipeptidyl peptidase-4 (DPP-4) inhibitors, glucagon-like peptide-1 (GLP-1) analogues, and thiazolidinediones (TZDs) all produced statistically significant reductions in hemoglobin A1C in combination with metformin and a sulphonylurea. Meglitinides and alpha-glucosidase inhibitors, however, did not. The addition of insulin neutral protamine Hagedorn (NPH) to metformin plus a sulfonylurea was associated with the most favourable cost-effectiveness estimates. CADTH’s Therapeutic Review Panel (TRP) recommended that, for most adults with type 2 diabetes inadequately controlled on metformin and a sulfonylurea, insulin NPH should be added as the third-line agent. Long-acting insulin analogues at prices similar to insulin NPH were also considered an option for patients inadequately controlled on metformin and a sulfonylurea.

CADTH Optimal Use Report - Canadian Agency for Drugs and Technologies in Health.

Version: July 2013
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Newer Agents for Blood Glucose Control in Type 2 Diabetes (Supplement) [Internet]

NICE issued an updated guideline (Clinical Guideline 66) for the management of all aspects of type 2 diabetes in May 2008. However new drug developments means that this guideline itself already requires an update. This technology assessment report aims to provide information to support the Short Guideline Development Group (GDG) which will produce a “new drugs update” to the 2008 guideline.

NICE Clinical Guidelines - National Institute for Health and Clinical Excellence (UK).

Version: May 2009
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Comparative effectiveness of dipeptidylpeptidase-4 inhibitors in type 2 diabetes: a systematic review and mixed treatment comparison

OBJECTIVE: To compare the safety and efficacy of the dipeptidylpeptidase-4 (DPP-4) inhibitors in patients with type 2 diabetes and inadequate glycemic control.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

Combination therapies of DPP4 inhibitors and GLP1 analogues with insulin in type 2 diabetic patients: a systematic review

OBJECTIVE: The use of dipeptidyl-peptidase 4 (DPP4) inhibitors and glucagon like peptide 1 (GLP1) analogues for the treatment of diabetic mellitus (DM) type 2 is growing. Currently some of these agents have been approved in combination with insulin.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Dipeptidyl peptidase-4 inhibitors and heart failure: a meta-analysis of randomized clinical trials

BACKGROUND & AIMS: Recently, the SAVOR TIMI-53 (Saxagliptin Assessment of Vascular Outcomes Recorded in patients with diabetes mellitus--Thrombolysis in Myocardial Infarction-53) reported a significant increase in the risk of hospitalizations for heart failure in patients treated with saxagliptin in comparison with placebo. Aim of the present meta-analysis is the systematic collection and synthesis of information on treatment-emergent cases of acute heart failure described in randomized clinical trials with DPP4.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

Safety of dipeptidyl peptidase-4 inhibitors: a meta-analysis of randomized clinical trials

OBJECTIVE: Dipeptidyl peptidase-4 inhibitors (DPP4i) have been recently associated with increased risk of pancreatitis and cancer. The aim of the present meta-analysis of randomized clinical trials is the assessment of the effect of DPP4i on the incidence of major cardiovascular events (MACE), cancer, and pancreatitis.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

Baseline glycemic parameters predict the hemoglobin A1c response to DPP-4 inhibitors: meta-regression analysis of 78 randomized controlled trials with 20, 053 patients

Ability to predict which patients might benefit more of therapy might facilitate personalization of treatment. The aim of this study was to obtain information about clinical characteristics which might predict the HbA1c response to DPP-4 inhibitors. We conducted an electronic search without restriction for randomized controlled trials (RCTs) involving DPP-4 inhibitors (vildagliptin, sitagliptin, saxagliptin, linagliptin, and alogliptin). RCTs were included if they lasted at least 12 weeks, reported the effect of DPP-4 inhibitors on HbA1c level, and the number of patients in any arm was >30. We did a meta-regression analysis. Seventy-eight articles were eligible, with 79 arms and 20,503 patients. For all arms, the decrease of HbA1c was -0.74 % (95 % CI -0.80 to -0.67 %), with considerable heterogeneity (I (2) = 97 %, P < 0.0001): the greatest HbA1c decrease was seen at 52 weeks (8 arms, 3,338 patients, -0.88 %, 95 % CI -1.10 to -0.66 %). In univariate meta-regression analysis, baseline HbA1c explained 22 % of variance of the HbA1c response to treatment, while fasting glucose and type of DPP-4 inhibitor explained an additional 19 and 12 %, respectively; age, duration of treatment, previous therapy, and type of statistical analysis of RCTs were without influence. In the multivariate meta-regression model, baseline HbA1c, fasting glucose, and type of DPP-4 inhibitor explained 61 % of total variance. The HbA1c response to DPP-4 inhibitors can be modulated mainly by baseline HbA1c and fasting glucose levels: a greater absolute reduction of baseline HbA1c is seen in patients with higher baseline HbA1c and lower fasting glucose level.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

DPP-4 inhibitors and lipids: systematic review and meta-analysis

This meta-analysis suggested a possible beneficial effect of DPP-4 inhibitors on cholesterol that was small but statistically significant and could contribute to reduction of cardiovascular risk. Evidence limitations, study heterogeneity and potential confounding factors mean that the authors' conclusions may not be reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

Glycaemic durability with dipeptidyl peptidase-4 inhibitors in type 2 diabetes: a systematic review and meta-analysis of long-term randomised controlled trials

OBJECTIVES: To evaluate glycaemic durability with dipeptidyl peptidase-4 (DPP-4) inhibitors in type 2 diabetes.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

Dipeptidyl peptidase-4 inhibitors and HbA1c target of <7% in type 2 diabetes: meta-analysis of randomized controlled trials

This review concluded that a greater proportion of type 2 diabetic patients could achieve the glycated haemoglobin target of below 7% with dipeptidyl peptidase-4 inhibitors compared with placebo, without weight gain or hypoglycaemic risk, but that dipeptidyl peptidase-4 inhibitors were not different from comparator drugs. Based on the results presented in the paper, these conclusions appear appropriate.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

Efficacy and safety of dipeptidyl peptidase-4 inhibitors and metformin as initial combination therapy and as monotherapy in patients with type 2 diabetes mellitus: a meta-analysis

AIMS: This meta-analysis was performed to provide an update on the efficacy and safety of dipeptidyl peptidase-4 (DPP-4) inhibitors and metformin as initial combination therapy and as monotherapy in patients with type 2 diabetes mellitus (T2DM).

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Efficacy and safety of dipeptidyl peptidase-4 inhibitors and metformin as initial combination therapy and as monotherapy in patients with type 2 diabetes mellitus: a meta-analysis

AIMS: This meta-analysis was performed to provide an update on the efficacy and safety of dipeptidyl peptidase-4 (DPP-4) inhibitors and metformin as initial combination therapy and as monotherapy in patients with type 2 diabetes mellitus (T2DM).

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

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