Less hypoglycaemia with sitagliptin compared to sulfonylurea

Researchers announced results from a post-hoc pooled analysis showing patients with type 2 diabetes and mild renal impairment treated with JANUVIA® (sitagliptin) 100 mg once-daily achieved similar blood sugar reductions as those treated with the sulfonylureas glipizide or glimepiride, with significantly fewer events of hypoglycaemia (low blood sugar), and with weight loss instead of weight gain. Results were presented at the American Diabetes Association 73rd Scientific Sessions.

“Chronic renal disease is, unfortunately, an increasingly common problem in patients with type 2 diabetes—and one which can complicate physicians’ management of their patients’ blood sugar control,” said Peter Stein, vice president of Clinical Research for diabetes and endocrinology, Merck Research Laboratories. “Treatments which can help patients with diabetes and renal insufficiency get to improved glycaemic control, without increasing the risk of hypoglycaemia, may be very useful.”

Patients taking JANUVIA 100 mg once-daily achieved similar blood sugar reductions (-0.62 LS mean A1Cⁱ reduction from a baseline of 7.6%) as patients taking a sulfonylurea (-0.68 LS mean A1C reduction from a baseline of 7.6%).

Of the patients taking JANUVIA® (sitagliptin), 6.8 percent experienced one or more episodes of symptomatic hypoglycemia, compared to 26.2 percent of patients taking a sulfonylurea (p<0.001). Patients taking JANUVIA also experienced weight loss (-0.9 kg or approximately 2 lbs.) compared to weight gain (+1.4 kg or approximately 3 lbs.) with a sulfonylurea (p<0.001).

JANUVIA is indicated, as an adjunct to diet and exercise, to improve glycaemic control in adults with type 2 diabetes mellitus. JANUVIA should not be used in patients with type 1 diabetes or for the treatment of diabetic ketoacidosis. JANUVIA has not been studied in patients with a history of pancreatitis. It is unknown whether patients with a history of pancreatitis are at increased risk of developing pancreatitis while taking JANUVIA. There have been no clinical studies establishing conclusive evidence of macrovascular risk reduction with JANUVIA or with any other antidiabetic drug.

Design of Post-hoc Analysis

This post-hoc analysis pooled data from three randomized, double-blind studies conducted over 25-30 weeks that included 1,180 patients with type 2 diabetes and mild renal insufficiencyⁱⁱ. The analysis compared the effects of JANUVIA 100 mg (n=584) once daily to a sulfonylurea, either glipizide or glimepiride (n=596) in titrated doses, on change from baseline in A1C, fasting plasma glucose, body weight, and the incidence of symptomatic hypoglycaemia.

JANUVIA is contraindicated in patients with a history of a serious hypersensitivity reaction to sitagliptin, such as anaphylaxis or angioedema.