Vildagliptin: ten years in the service for type 2 diabetes mellitus patients. The journey of discovery, innovation and success in clinical practice
https://doi.org/10.14341/probl9746
Abstract
Type 2 diabetes mellitus is a multifactorial multiorgan disease. Over the last decade, the implementation of brand-new therapeutic opportunities led to tremendous rise of research studies in the field of diabetes as well as to shift in priorities of the management of patients with type 2 diabetes from a glucocentric approach and towards holistic control of the key underlying pathophysiological processes of the disease development and progression. The use of dipeptidyl peptidase-4 inhibitors shows good glycemic control because of physiological glucose — dependent mechanism of action mediated with the improvement of incretin hormones effects. Moreover, dipeptidyl peptidase-4 inhibitors have a wide range of pleiotropic effects owning to additional properties of incretins and inhibition of dipeptidyl peptidase enzymatic activity, which leads to beneficial impact on metabolic and pathogenetic processes of type 2 diabetes mellitus. Dipeptidyl peptidase-4 inhibitors are effective drugs with good safety profile as for risks related to type 2 diabetes and have no limitative disadvantages such as hypoglycemia and weight gain. This publication reviews vildagliptin, the first developed dipeptidyl peptidase-4 inhibitor, with an emphasis on its use in different clinical settings of diabetes management.
About the Author
Tatiana Yu. DemidovaPirogov Russian National Research Medical University; Russian Medical Academy of Continuous Professional Education
Russian Federation
MD, PhD, Professor
Competing Interests:
Демидова Т.Ю. — лектор, участник экспертных советов, клинических исследований компаний Astra Zeneca, Novo Nordisk, Sanofi, Novartis, Boehringer Ingelheim, Takeda, Berlin Chemi.
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Supplementary files
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1. Fig. 1. Changes in the level of HbA1c in groups with different therapy of T2DM [38]. | |
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2. Fig. 2. The average change in the level of HbA1c (A) and GPN (B) in patients receiving IDPP-4 [45]. | |
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3. Fig. 3. Nomogram for assessing ΔHbA1c when choosing DPP-4. How to use: (1) select the inhibitor and (2) the initial level of HbA1c, then (3) lower the perpendicular on the “points” scale, (4) similarly for the FPG. (5) The total scores of the initial HbA1c and HFN correspond to the expected decrease in the level of HbA1c when taking the selected inhibitor [46]. | |
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4. Fig. 4. Dynamics of the level of GLP-1 and glucagon during the day [50]. | |
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5. Fig. 5. The risk relationship of the Mantel-Henzel combination endpoint and its individual components in the treatment with vildagliptin and comparator drugs [57]. | |
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6. Fig. 6. The effectiveness of vildagliptin in comparison with PSM with the addition of metformin - the comparison of the results of RCT and RCP [53]. | |
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7. Fig. 7. Average ΔHbA1c according to the GUARD study; * p <0.0001 compared with baseline [60]. | |
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8. Fig. 8. The risk ratio of complications of type 2 diabetes when taking vildagliptin and PSM [62]. | |
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For citations:
Demidova T.Yu. Vildagliptin: ten years in the service for type 2 diabetes mellitus patients. The journey of discovery, innovation and success in clinical practice. Problems of Endocrinology. 2018;64(5):336-347. https://doi.org/10.14341/probl9746
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