The position of new antidiabetics in clinical practice: SGLT2 vs DPP4 inhibitors
Authors:
Jan Šoupal; Martin Prázný
Authors‘ workplace:
III. interní klinika 1. LF UK a VFN Praha, přednosta prof. MUDr. Štěpán Svačina, DrSc., MBA
Published in:
Vnitř Lék 2015; 61(4): 291-294
Category:
Reviews
Overview
SGLT2 and DPP4 inhibitors are new effective oral antidiabetic drugs with low risk of hypoglycemia and positive or neutral impact on body weight. These characteristics are substantially different from more widely used sulphonylureas. Current treatment of type 2 diabetes is rather complicated. Moreover, the position of new antidabetics in the guidelines has not yet been clearly defined. Personalised treatment on the basis of molecular markers is still not possible. Therefore, the position of new antidiabetics in the treatment of type 2 diabetes is often determined by clinical experience and subsequently modified by new clinical studies. Currently, doctors are asking which of these modern antidabetics to choose. The following text might help in this decision.
Key words:
DPP4 inhibitors – HbA1c – SGLT2 inhibitors – type 2 diabetes
Sources
1. Péče o nemocné cukrovkou 2012. ÚZIS ČR: Praha 2013. ISBN 978–80–7472–082–6.
2. Inzucchi SE, Bergenstal RM, Buse JB et al. Management of Hyperglycemia in Type 2 Diabetes, 2015: A Patient-Centered Approach: Update to a Position Statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care 2015; 38(1): 140–149.
3. Svačina Š. Jak se mění možnosti léčby obézních diabetiků 2. typu. Vnitř Lék 2014; 60(10): 902–907.
4. Tahrani AA, Barnett AH, Bailey CJ. SGLT inhibitors in management of diabetes. Lancet Diabetes Endocrinol 2013; 1(2): 140–151.
5. Rosenwasser RF, Sultan S, Sutton D et al. SGLT-2 inhibitors and their potential in the treatment of diabetes. Diabetes Metab Syndr Obes 2013; 6: 453–467.
6. Scheen AJ. A review of gliptins in 2011. Expert Opin Pharmacother 2012; 13(1): 81–99.
7. Schernthaner G, Gross JL, Rosenstock J et al. Canagliflozin compared with sitagliptin for patients with type 2 diabetes who do not have adequate glycemic control with metformin plus sulfonylurea: a 52-week randomized trial. Diabetes Care 2013; 36(9):2508–2515. Dostupné z DOI: <http://dx.doi.org/10.2337/dc12–2491>.
8. Rosenstock J, Seman LJ, Jelaska A et al. Efficacy and safety of empagliflozin, a sodium glucose cotransporter 2 (SGLT2) inhibitor, as add-on to metformin in type 2 diabetes with mild hyperglycaemia. Diabetes Obes Metab 2013; 15(12):1154–1160. Dostupné z DOI: <http://dx.doi.org/10.1111/dom.12185>.
9. Rosenstock J, Hansen L, Zee P et al. Dual Add-on Therapy in Type 2 Diabetes Poorly Controlled With Metformin Monotherapy: A Randomized Double-Blind Trial of Saxagliptin Plus Dapagliflozin Addition Versus Single Addition of Saxagliptin or Dapagliflozin to Metformin. Diabetes Care 2015; 38(3):376–383.
10. Hardy E, Rohwedder K, Hruba V et al. Dapagliflozin, an SGLT2 Inhibitor, reduces Serum Levels of Uric Acid in patients with Type 2 Diabetes. Presented at 71st American Diabetes Association Scientific Sessions; June 24–28, 2011; San Diego, CA, USA.
11. Meier JJ, Nauck MA. Risk of pancreatitis in patients treated with incretin-based therapies. Diabetologia 2014; 57(7): 1320–1324.
12. Scirica BM, Bhatt DL, Braunwald E et al. Saxagliptin and cardiovascular outcomes in patients with type 2 diabetes mellitus. N Engl J Med 2013; 369(14): 1317–1326.
13. White WB, Cannon CP, Heller SR et al. EXAMINE Investigators. Alogliptin after acute coronary syndrome in patients with type 2 diabetes. N Engl J Med 2013; 369(14): 1327–1335.
14. Pratley RE. Linagliptin use in older individuals with type 2 diabetes. Clin Interv Aging 2014; 9: 1109–1114.
15. Cefalu W, Leiter L, de Bruin T et al. Dapagliflozin Treatment for Type 2 Diabetes Mellitus patietns with Comorbid Cardiovascular Disease and Hypertension. Presented at 72nd American Diabetes Association Scientific Sessions; June 8–12, 2012; Philadelphia, PA, USA.
16. Bode B, Stenlof K, Sullivan D et al. Efficacy and safety of canagliflozin (CANA), a sodium glucose cotransporter 2 inhibitor (SGLT2), in older subjects with type 2 diabetes mellitus. Presented at 48th EASD Annual Meeting; October 1–5, 2012; Berlin, Germany.
17. SPC – Souhrn údajů o přípravku Forxiga (dapagliflozin). 2014. Dostupné z WWW: <http://www.astrazeneca.cz/kardiologie/Forxiga_10mg_SPC.pdf>.
18. SPC – Souhrn údajů o přípravku Jardiance (empagliflozin). 2014. Dostupné z WWW: <http://ec.europa.eu/health/documents/community-register/2014/20140522128562/anx_128562_cs.pdf>.
19. Palička V, Lesná J, Pavlíková L Změny kostního metabolizmu u diabetiků. Vnitř Lék 2014; 60(9): 742–745.
20. Dormandy J, Bhattacharya M, van Troostenburg de Bruyn AR. PROactive investigators. Safety and tolerability of pioglitazone in high risk patients with type 2 diabetes: an overview of data from PROactive. Drug Saf 2009; 32(3): 187–202.
21. Bunck MC, Poelma M, Eekhoff EM et al. Effects of vildagliptin on postprandial markers of bone resorption and calcium homeostasis in recently diagnosed, well-controlled type 2 diabetes patients. J Diabetes 2012; 4(2): 181–185.
22. Avogaro A, Schernthaner G. Achieving glycemic control in patients with type 2 diabetes and renal impairment. Acta Diabetol 2013; 50(3): 283–291.
23. Groop PH, Cooper ME, Perkovic V et al. Linagliptin lowers albuminuria on top of recommended standard treatment in patients with type 2 diabetes and renal dysfunction. Diabetes Care 2013; 36(11): 3460–3468.
24. Gilbert RE. SGLT-2 inhibition in patients with kidney disease. Diabetes Metab 2014; 40(6 Suppl 1): S23-S27.
25. DeFronzo RA, Lewin A, Patel S et al. Fixed-dose combinations of empagliflozin/linagliotin for 24 weeks as add-on to metformin in patients with type 2 diabetes (T2DM) (Abstract). Diabetes 2014; 63(Suppl 1A): LB33.
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Diabetology Endocrinology Internal medicineArticle was published in
Internal Medicine
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