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Vildagliptin improves HbA1c, does not affect body weight in type 2 diabetes
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Adults with uncontrolled type 2 diabetes assigned to the DPP-IV inhibitor vildagliptin as an add-on to metformin experienced greater glycemic control without an apparent increase in body weight, study data show.
Gabriel Chodick, PhD, of Maccabi Healthcare Services and Tel Aviv University in Israel, and colleagues evaluated data from the Maccabi Healthcare Services on 345 adults with type 2 diabetes (mean age, 61 years; 54% men) to determine the effect of at least 90 days of vildagliptin (mean daily dose, 91.8 mg) as an add-on to metformin on HbA1c, body weight and serum lipid levels.
HbA1c decreased by 0.9% after 3 months of treatment (P < .001). The reduction was at least 0.7% in more than half of participants (51.6%), and 47.4% achieved an HbA1c of 7% or lower.
After treatment, researchers observed statistically significant reductions in body mass (–0.75 kg), BMI (–0.29 kg/m2) and LDL cholesterol (–4.05 mg/dL), but no significant changes in HDL cholesterol; 38% of participants lost at least 1 kg in body weight.
At 1 year, 88 participants were examined for liver enzymes; 4.3% had a more than threefold increase and 2% had a 10-fold increase in alanine aminotransferase and aspartate aminotransferase from normal range. However, no kidney failure or rhabdomyolysis events were reported.
Through follow-up, 2% of participants died, and mean age at death was 79.4 years.
“This analysis of real-world data corroborates the results of previous [randomized controlled trials] indicating that add-on therapy with vildagliptin in uncontrolled patients on metformin is associated with a significant reduction in HbA1c, with no indication of weight gain or increased non-HDL blood lipids,” the researchers wrote. “Future studies on long-term outcomes among vildagliptin users and time to insulin injection initiation are important to examine the safety and effectiveness of the medication.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures. The study was funded by Novartis.
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