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

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

15 March 2012

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: None declared

Madhavan Nampoothiri, Lecturer

Manipal University, Department of Pharmacology, Manipal College of Pharmaceutical Sciences, Manipal university, Karnataka, India-576104

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