Incretin-based therapies for type 2 diabetes mellitus in Asian patients: Analysis of clinical trials
DOI:
https://doi.org/10.13181/mji.v19i3.406Keywords:
exenatide, incretin, liraglutide, sitagliptin, type-2 diabetes, vildagliptinAbstract
Aim To review the effi cacy and safety data on incretin-based therapies currently available (exenatide, liraglutide, sitagliptin, vildagliptin) for the treatment of type 2 diabetes mellitus in Asian population.
Methods We conducted Medline search of all relevant randomized clinical trials of incretin-based therapies for type 2 diabetes mellitus in Asian populations. Data pertinent to the efficacy and safety of GLP-1 mimetics and DPP-4 inhibitors were extracted and used.
Results We found 14 randomized controlled trials of incretin based-therapy which included 3567 type 2 diabetes mellitus in Asian population (Japanese, Chinese, Korean, Indian). It was shown that incretin-based therapies improved HbA1c at higher extent (up to -1.42% in exenatide 10 mcg bid, -1.85% for liraglutide 0.9 mg qd, -1.4% for sitagliptin 100 mg and -1.4% for vildagliptin 50 mg bid) compared to the effects observed in studies with Caucasian population, with comparable safety profile.
Conclusion The efficacy of incretin-based therapies in Asian patients improved glycemic parameters in a higher magnitude on some glycemic parameters compared with those in Caucasian population. These results indicate that incretin-based therapies may be more effective in Asian population than in Caucasian. (Med J Indones 2010; 19: 205-12)
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Article in Press. Lancet. October 28, 2009.Wild S, Roglic G, Green A, Sicree R, King G. Global 2. prevalence of diabetes. Estimates for the year 2000 and projections for 2030. Diab Care. 2004; 27:1047 – 52.Yoon KH, Lee JH, Kim JW, Cho JH, Choi YH, Ko SH, et 3. al. Epidemic obesity and type 2 diabetes in Asia. Lancet. 2006; 368:1681 – 8..Cockram CS. Diabetes mellitus: perspective from the Asia- 4. Pacifi c region. Diab Res Clin Pract. 2000;50 (Suppl 2): S3-7.Unger RH, Zhou YT. Lipotoxicity of beta cells in obesity 5. and in other cause of fatty acid spillover. Diabetes. 2001; 1: S118-21. Chturvedi N, Stevens LK, Fuller JH, Lee ET, Lu M. 6. The WHO Multinational Study Group, Risk factors, ethnic differences and mortality associated with lower-extremity gangrene and amputation in diabetes. The WHO multinational study of vascular disease in diabetes. Diabetologia. 2001; 44 (Suppl 2): S65 – 71. Lee ET, Keen H, Bennett PH, Fuller JH, Lu M. The WHO 7. Multinational Study Group, WHO Multinational Study Group: Follow-up of the WHO Multinational study of vascular disease in diabetes: general description and morbidity. Diabetologia. 2001; 44 (Suppl 2): S3:13.The DECODE-DECODA Study Group, Age, body mass 8. index and type 2 diabetes: associations modifi ed by ethnicity, Diabetologia. 2003; 46: 1063 – 70.The DECODA study Group. Age- and sex- specifi c 9. prevalence of diabetes and impaired glucose regulation in 11 Asian cohorts. Diab Care. 2003; 26: 1770 – 80.Seino Y. Relevance of incretins in the treatment of Asian patients 10. with Type 2 diabetes. Diab Res Clin Pract. 2008; 79: S4. Takeuchi M, Okamoto K, Takagi T, Ishii H. Ethnic 11. difference in patients with type 2 diabetes mellitus in inter-East Asian populations: A systematic review and meta-analysis focusing on fasting serum insulin. Diab Res Clin Pract. 2008; 81: 370 – 6. Fukushima M, Suzuki H, Seino Y. Insulin secretion capacity 12. in the development from normal glucose tolerance to type 2 diabetes. Diab Res Clin Pract. 2004; 66S: S37-43. Holst JJ, Vilsboll T, Deacon CF. The incretin system and its 13. role in type 2 diabetes mellitus. Mol Cell Endocrinol. 2009; 297: 127 – 36. Nauck M, Stockman F, Ebert R, Creutzfeldt W. Reduced 14. incretin effect in type 2 (non-insulin-dependent) diabetes. Diabetologia. 1986; 29: 46 – 52. Kendall DM, Cuddihy RM, Bergenstal RM. Clinical 15. application of incretin-based therapy: Therapeutic potential, patient selection and clinical use. Am J Med. 2009; 122: S37 – 50.Verspohl EJ. Novel therapeutics for type 2 diabetes: Incretin 16. hormone mimetics (glucagons-like peptide-1 receptor agonists) and dipeptidyl peptidase-4 inhibitors. Pharm Ther. 2009; 124: 113 – 38. Gao Y, Yoon KH, Chiang LM, Mohan V, Ning G, Shah S, 17. et al. Effi cacy and safety of exenatide in patients of Asian descent with type2 diabetes inadequately controlled with metformin or metformin and a sulphonylurea. Diab Res Clin Pract. 2009; 83: 69 – 76.Kadowaki T, Namba M, Yamamura A, Sowa H, Wolka AM, 18. et al. Exenatide exhibits dose-dependent effects on glycemic control over 12 weeks in Japanese patients with suboptimally controlled type 2 diabetes. Endocr J. 2009; 56:415 – 24. Iwamoto K, Nasu R, Yamamura A, Kothare PA, Mace K, Wolka 19. AM, Linnebjerg H. Safety, tolerability, pharmacokinetics, and pharmacodynamics of exenatide once weekly in Japanese patients with type 2 diabetes. Endocr J. August 25, 2009. Khoo J, Rayner CK, Jones KL, Horowitz M. Incretin-based 20. therapies: new treatments for type 2 diabetes in the new millennium. Ther Clin Risk Manag. 2009;5: 683 – 98.Seino Y, Rasmussen MF, Zdravkovic M, Kaku K. Dose-21. dependent improvement in glycemia with once-daily liraglutide without hypoglycemia or weight gain: A double-blind, randomized, controlled trial in Japanese patients with type 2 diabetes. Diab Res Clin Pract. 2008;81:161 – 8.Seino Y, Rasmussen MF, Katayama Y, Kaku K. Liraglutide 22. is statistically superior to glibenclamide at controlling glycemia and weight, with low hypoglycemic risk, and improves beta-cell function in Japanese subjects with T2D; Abstracts of the American Diabetes Association (ADA) 69th scientifi c session. 2009. Abstract 536-P.Seino Y, Rasmussen MF, Katayama Y, Kaku K. The human 23. GLP-1 analogue liraglutide given once daily provides excellent metabolic control in Japanese patients either as monotherapy or in combination with SU during 52 weeks of treatment. Diabetologia. 2009; 52 (Suppl 1): S292.Iwamoto Y, Nonaka K, Okada A, Okuyama K, Stein PP. 24. Dose-response relationship for glycemic effi cacy, safety and tolerability of sitagliptin after 12 weeks of treatment in Japanese patients with type 2 diabetes mellitus. Diabetologia. 2007; 50 (Suppl 1): S366.Kadowaki T, Tajima N, Odawara M, Nishii M, Nonaka 25. K, Stein PP. Sitagliptin added to ongoing treatment with metformin improved glycemic control and was well tolerated in Japanese patients with type 2 diabetes (T2DM); Abstracts of the American Diabetes Association (ADA) 68th scientifi c session. 2008. Abstract 2135-PO.Mohan V, Yang W, Son HY, Xu L, Noble L, Langdon RB, 26. et al. Effi cacy and safety of sitagliptin in the treatment of patients with type 2 diabetes in China, India and Korea. Diab Res Clin Pract. 2009; 83:106-16. Chan JCN, Scott R, Ferreira JCA, Sheng D, Gonzales E, 27. Davies MJ, et al. Safety and effi cacy of sitagliptin in patients with type 2 diabetes and chronic renal insuffi ciency. Diab Obes Metab. 2008; 10: 545 – 55. Maegawa H, Kashiwagi A, Tajima N, Kadowaki T, Nonaka 28. K, Okamoto T. Diabetologia. 2008; 51 (Suppl 1): S 365. Nonaka K, Kakikawa T, Sato A, Okuyama K, Fujimoto G, 29. Kato N, et al. Diab Res Clin Pract. 2008; 79 : 291 – 8. NCT00411554. Study of Sitagliptin in patients with type 30. 2 diabetes mellitus who have inadequate glycemic control on diet/exercise therapy. Available URL: www.clinicaltrials.gov Kikuchi M, Abe N, Kato M, Terao S, Mimori N, Tachibana 31. H. Vildagliptin dose-dependently improves glycemic control
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