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Fixed-dose combination therapy for type 2 diabetes: sitagliptin plus pioglitazone
Clifford J Bailey1, Brian D Green, Peter R Flatt
1Aston University, Department of Life and Health Sciences, Birmingham, UK. c.j.bailey@aston.ac.uk
Expert Opinion on Investigational Drugs
|July 16, 2010
Summary
A new single-tablet combination of sitagliptin (a DPP-4 inhibitor) and pioglitazone effectively lowers blood glucose in type 2 diabetes patients. This combination therapy is well-tolerated and suitable for daily use.
Area of Science:
- Endocrinology
- Pharmacology
- Metabolic Diseases
Background:
- Type 2 diabetes involves insulin resistance and pancreatic beta-cell dysfunction.
- Combination therapy is often necessary to address these defects.
- Sitagliptin (DPP-4 inhibitor) and pioglitazone (thiazolidinedione) target different aspects of glucose control.
Purpose of the Study:
- To evaluate the efficacy and tolerability of a fixed-dose combination of sitagliptin and pioglitazone.
- To assess the potential of a single-tablet formulation for type 2 diabetes management.
Main Methods:
- Clinical trials utilized sitagliptin (100 mg/day) and pioglitazone (30-45 mg/day) as separate tablets.
- Evaluated as initial therapy and as add-on therapy to pioglitazone.
Main Results:
- Initial combination therapy (sitagliptin 100 mg/day, pioglitazone 30 mg/day) reduced HbA1c by >2% from baseline >9%.
- Add-on sitagliptin (50-100 mg/day) to pioglitazone reduced HbA1c by 0.7-1.4% (baseline 8-8.5%).
- The combination showed no increased hypoglycemia risk and similar or slightly greater weight gain compared to pioglitazone alone.
Conclusions:
- The sitagliptin-pioglitazone combination was well-tolerated.
- A fixed-dose single-tablet combination for once-daily administration is suitable.
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