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Januvia superior to Basen for antihyperglycemic effects
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Compared with treatment with the alpha-glucosidase inhibitor Basen, treatment with the DPP-IV inhibitor Januvia resulted in superior antihyperglycemic effects, according to results from a Japanese study.
However, unique pleiotropic effects that reduced cardiovascular risk were evident with both agents, the researchers wrote.
Toshinari Takamura, MD, PhD, professor in the faculty of medicine at Kanazawa University Graduate School of Medical Sciences in Japan, and colleagues evaluated adults (mean age, 63.2 years) with type 2 diabetes randomly assigned to Januvia (sitagliptin, Merck) 50 mg once daily (n = 120) or Basen (voglibose, Takeda) 0.6 mg three times per day (n = 121) for 12 weeks to determine HbA1c and other effects between the two treatments.
Both groups had significantly decreased fasting plasma glucose and HbA1c at the end of the study compared with baseline; however, the sitagliptin group had a greater reduction in HbA1c (–0.78% vs. –0.3%) and FPG (–16.2% vs. –4.4%) relative to baseline compared with voglibose.
Compared with the voglibose group, the sitagliptin group experienced increases in neutrophil count (P = .008) and reductions in lymphocyte counts (P = .001) and alkaline phosphatase. LDL cholesterol and tumor necrosis factor-alpha were significantly increased with voglibose. Adiponectin levels significantly increased with both treatments.
Adverse events were less common with sitagliptin compared with voglibose, according to the researchers.
“We showed that sitagliptin is superior to voglibose in terms of improving glycemic control as a first/second-line therapy in Japanese people with type 2 diabetes,” the researchers wrote. “However, both agents exert unique pleiotropic effects on surrogate [CV] risks, which suggests a theoretical basis for potential benefits through combined therapy. A large-scale clinical trial on CV events is required to test this hypothesis.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.
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