New oral drug for type 2 diabetes shows promise
The first of a new class of oral antidiabetic drugs is able to lower blood sugar (glucose) in type 2 diabetes as well as Avandia (rosiglitazone) does, but without causing weight gain, according to a report in the journal Diabetes Care.
The new agent, vildagliptin, also known by the brand name Galvus, is awaiting regulatory approval in the U.S. and Europe. The new drug class, dipeptidyl peptidase-IV (DPP-IV) inhibitors, improves cell responsiveness to glucose, the authors explain.
Dr. Julio Rosenstock from the Dallas Diabetes and Endocrine Center, and colleagues compared the effectiveness and tolerability of vildagliptin versus rosiglitazone (the generic name for Avandia) in nearly 800 patients with previously untreated type 2 diabetes.
At the beginning of the study, the patients’ average hemoglobin A1c level (HbA1c), a measure of long-term glucose control, was 8.7 percent. (Normal HbA1c levels are less than 7 percent). It decreased by 1.1 percent with vildagliptin treatment, with most of the decrease occurring within the first 12 weeks, the investigators report. Patients treated with rosiglitazone had a 1.3 percent decrease in HbA1c, with maximum reduction occurring at week 16.
Patients who were not obese (body mass index below 30) fared better than heavier patients with vildagliptin, the team found.
Vildagliptin treatment was associated with stable body weight during treatment and a significant decrease in the “bad” cholesterol, including triglycerides, LDL, and non-HDL cholesterol, compared with rosiglitazone treatment, the researchers note. Patients taking rosiglitazone experienced a significant average increase in weight of about 3.5 pounds.
Vidlagliptin and rosiglitazone are both effective in reducing blood glucose levels in type 2 diabetes patients who have not received prior anti-diabetic drug treatment, the investigators conclude. Along with being well-tolerated, vildagliptin does not cause weight gain, which is an important consideration in selecting the first drug to treat type 2 diabetes patients.
SOURCE: Diabetes Care, February 2007.
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