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Sitagliptin superior to glipizide for HbA1c, hypoglycemia, weight gain outcomes
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ADA 70th Scientific Sessions
ORLANDO — Significantly more patients treated with sitaglitpin for 1 year achieved a composite endpoint of HbA1c reduction greater than 5% and no hypoglycemia or weight gain compared with patients treated with glipizide.
Results of a post hoc analysis that compared the dipeptidyl peptidase-4 inhibitor and sulfonylurea showed that 38.1% of patients assigned to sitagliptin experienced the composite endpoint in 1 year vs. 11.8% assigned to glipizide, for a between-group difference of 26.3%.
Further, the odds ratio for achieving the composite endpoint was also greater with sitagliptin compared with glipizide (5.43; 95% CI, 3.7-7.9).
Researchers randomly assigned patients with uncontrolled diabetes to sitagliptin 100 mg (Januvia, Merck) or glipizide 5 mg per day. The group was also taking metformin monotherapy.
A significantly higher proportion of patients with a baseline HbA1c of 8% or higher achieved the composite endpoint in the sitagliptin group vs. glipizide group (55.8% vs. 31.7%) as well as patients with a HbA1c less than 8% (20.9% vs. 8.3%).
The abstract by Dr. Seck et al compares sitagliptin with use of a sulfonylurea. Using a composite endpoint of a reduction in HbA1C of greater than 0.5%, no weight gain and no hypoglycemia, a significantly larger proportion of patients achieved these goals using sitagliptin compared with glipizide. The reduction in HbA1C was nearly identical in both groups. However, because of the issue of weight gain and hypoglycemia with sulfonylureas, it is clearly advantageous to utilize sitagliptin
–Helena W. Rodbard, MD
Medical Director,
Endocrine and Metabolic Consultants, Rockville, Md.
For more information:
- Seck TL. 580-P. Presented at: The American Diabetes Association 70th Scientific Sessions; June 25-29, 2010; Orlando.
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