Efficacy of Omarigliptin, Once-weekly Dipeptidyl Peptidase-4 Inhibitor, in Patients with Type 2 Diabetes

Overview

Journal World J Diabetes

Publisher Baishideng Publishing Group

Specialty Endocrinology

Date 2022 Jan 20

PMID 35047122

Authors

Eiji Kawasaki

Yuko Nakano

Takahiro Fukuyama

Aira Uchida

Yoko Sagara

Hidekazu Tamai

Masayuki Tojikubo

Yuji Hiromatsu

Nobuhiko Koga

Affiliations

Soon will be listed here.

Abstract

Background: Omarigliptin is one of several once-weekly dipeptidyl peptidase-4 inhibitors (DPP-4is). Despite the high frequency of switching from various daily DPP-4is to omarigliptin in actual clinical practice, data regarding its efficacy in patients with type 2 diabetes (T2D) after switching are limited.

Aim: To analyze the efficacy of omarigliptin in Japanese patients with T2D who had previously received treatment with other glucose-lowering agents.

Methods: Forty-nine T2D patients treated for the first time with omarigliptin were recruited retrospectively and divided into four groups defined as either add-on or switched from daily DPP-4is: switched from linagliptin, switched from sitagliptin, and switched from vildagliptin. During a 3-mo follow-up, the clinical parameters among these groups were assessed and compared, with the impact of the switch on glycemic variability as measured by continuous glucose monitoring also being evaluated in the switched groups.

Results: Hemoglobin A1c levels saw a significant decrease of -0.32% ± 0.41% in the add-on group ( = 0.002). However, the other groups' variables depended on the pre-switch daily DPP-4i: switched from linagliptin, -0.05% ± 0.22%; switched from sitagliptin, -0.17% ± 0.33%; and switched from vildagliptin, 0.45% ± 0.42%, which saw significant worsening ( = 0.0007). Multivariate logistic regression analysis revealed that switching from vildagliptin to omarigliptin was independently associated with worsening glycemic control ( = 0.0013). The mean and standard deviation of sensor glucose value, the mean amplitude of glycemic excursions, and the mean of daily difference significantly improved when switching the patient from either linagliptin or sitagliptin to omarigliptin. However, in patients switched from vildagliptin, not only did the glucose variability indices see no improvements, the mean of daily difference even underwent significant worsening.

Conclusion: Administering omarigliptin as add-on therapy or switching to it from sitagliptin and linagliptin, but not vildagliptin, improves glycemic control and thus should help in decision making when selecting DPP-4is for T2D patients.

Citing Articles

Efficacy and Safety of Omarigliptin, a Novel Once-Weekly Dipeptidyl Peptidase-4 Inhibitor, in Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis.

Kamrul-Hasan A, Alam M, Talukder S, Dutta D, Selim S Endocrinol Metab (Seoul). 2024; 39(1):109-126.

PMID: 38417828 PMC: 10901664. DOI: 10.3803/EnM.2023.1839.

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