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Dipeptidyl peptidase-4 inhibitors for treatment of type 2 diabetes mellitus in the clinical setting: systematic review and meta-analysis

BMJ 2012; 344 doi: http://dx.doi.org/10.1136/bmj.e1369 (Published 12 March 2012) Cite this as: BMJ 2012;344:e1369

Re: Dipeptidyl peptidase-4 inhibitors for treatment of type 2 diabetes mellitus in the clinical setting: systematic review and meta-analysis

Thanks for having a detailed study on DPP-IV inhibitors. DPP-IV had grown as a promising target in type -2 diabetes. The long term efficacy of the drugs belonging to this class is still questionable.
It is learned that it is better to have a combination therapy using DPP-IV inhibitors with metformin to achieve a better glycaemic control. US FDA has approved the use of sitagliptin in combination with metformin marketed as JANUMET. The information regarding the efficacy of the combination in current clinical setting is inadequete.
There are post marketing reports of acute pancreatitis including the severe forms, hemorrhagic or necrotizing pancreatitis in patients using sitagliptin. The effect of these drugs on renal system is not clear.Studies are awaited on DPP-IV inhibitors to establish its place among the current therapeutic targets for the treatment of type-2 DM.

Competing interests: No competing interests

15 March 2012
Madhavan Nampoothiri
Lecturer
Manipal University
Department of Pharmacology, Manipal College of Pharmaceutical Sciences, Manipal university, Karnataka, India-576104
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