Efficacy and safety of sitagliptin monotherapy and combination therapy in Japanese type 2 diabetes patients.
(J Diabetes Invest, doi: 10.1111/j.2040-1124.2012.00221.x, 2012) Aims/Introduction:  To determine the efficacy and safety of sitagliptin monotherapy and combination therapy in Japanese type 2 diabetes patients after 3 months' therapy.


METHODS
A retrospective, observational study of 741 type 2 diabetes patients was carried out; 110 received sitagliptin monotherapy, and 631 received combination therapy with sitagliptin when other oral medications were insufficient. The primary outcome measure was glycated hemoglobin (HbA1c) measured at 0, 4 and 12 weeks of sitagliptin therapy.


RESULTS
In the monotherapy and combination therapy groups, HbA1c decreased significantly after 12 weeks. Target HbA1c (<7%) was achieved in 39.1% overall. On logistic regression analysis, baseline HbA1c was the strongest contributing factor for achieving target HbA1c; baseline body mass index and duration of diabetes were also significant factors. A total of 82 patients (11%) were unresponsive to sitagliptin. These patients' baseline body mass index was significantly higher and their baseline HbA1c was significantly lower than those of patients who responded to sitagliptin. The most commonly co-administered drugs were sulfonylureas (508 patients). In these patients, the dose of sulfonylurea decreased with time. In 66 patients whose sulfonylurea dosage was reduced when sitagliptin was started, HbA1c and bodyweight decreased significantly after 12 weeks. A total of 24 patients receiving sulfonylureas had mild hypoglycemia, but none discontinued sitagliptin.


CONCLUSIONS
Sitagliptin was effective and safe as both monotherapy and combination therapy in Japanese type 2 diabetes patients. When sulfonylureas were ineffective, sitagliptin improved glycemic control. In patients whose sulfonylurea dose was reduced at the start of sitagliptin, blood glucose improved and bodyweight decreased after 12 weeks.
The Study Group of the Diabetes Committee, Kanagawa Physicians Association.
Akira
A
Kubota
The Study Group of the Diabetes Committee, Kanagawa Physicians Association.
Hajime
H
Maeda
The Study Group of the Diabetes Committee, Kanagawa Physicians Association.
Akira
A
Kanamori
The Study Group of the Diabetes Committee, Kanagawa Physicians Association.
Kiyokazu
K
Matoba
The Study Group of the Diabetes Committee, Kanagawa Physicians Association.
Yasuyuki
Y
Jin
The Study Group of the Diabetes Committee, Kanagawa Physicians Association.
Fuyuki
F
Minagawa
The Study Group of the Diabetes Committee, Kanagawa Physicians Association.
Mitsuo
M
Obana
The Study Group of the Diabetes Committee, Kanagawa Physicians Association.
Kotaro
K
Iemitsu
The Study Group of the Diabetes Committee, Kanagawa Physicians Association.
Shogo
S
Ito
The Study Group of the Diabetes Committee, Kanagawa Physicians Association.
Hikaru
H
Amamiya
The Study Group of the Diabetes Committee, Kanagawa Physicians Association.
Mizuki
M
Kaneshiro
The Study Group of the Diabetes Committee, Kanagawa Physicians Association.
Masahiko
M
Takai
The Study Group of the Diabetes Committee, Kanagawa Physicians Association.
Hideaki
H
Kaneshige
The Study Group of the Diabetes Committee, Kanagawa Physicians Association.
Kazuhiko
K
Hoshino
The Study Group of the Diabetes Committee, Kanagawa Physicians Association.
Masashi
M
Ishikawa
The Study Group of the Diabetes Committee, Kanagawa Physicians Association.
Nobuaki
N
Minami
The Study Group of the Diabetes Committee, Kanagawa Physicians Association.
Tetsuro
T
Takuma
The Study Group of the Diabetes Committee, Kanagawa Physicians Association.
Nobuo
N
Sasai
The Study Group of the Diabetes Committee, Kanagawa Physicians Association.
Sachio
S
Aoyagi
The Study Group of the Diabetes Committee, Kanagawa Physicians Association.
Takehiro
T
Kawata
The Study Group of the Diabetes Committee, Kanagawa Physicians Association.
Atsuko
A
Mokubo
The Study Group of the Diabetes Committee, Kanagawa Physicians Association.
Hiroshi
H
Takeda
The Study Group of the Diabetes Committee, Kanagawa Physicians Association.
Shin
S
Honda
The Study Group of the Diabetes Committee, Kanagawa Physicians Association.
Hideo
H
Machimura
The Study Group of the Diabetes Committee, Kanagawa Physicians Association.
Tetsuya
T
Motomiya
The Study Group of the Diabetes Committee, Kanagawa Physicians Association.
Manabu
M
Waseda
The Study Group of the Diabetes Committee, Kanagawa Physicians Association.
Yoshikazu
Y
Naka
Division of Metabolism and Endocrinology, Department of Internal Medicine, St. Marianna University School of Medicine.
Yasushi
Y
Tanaka
Department of Endocrinology and Diabetes, Yokohama City University Medical Center, Kanagawa, Japan.
Yasuo
Y
Terauchi
The Study Group of the Diabetes Committee, Kanagawa Physicians Association.
Ikuro
I
Matsuba
Diabetes mellitus; Sitagliptin; Sulfonylurea