title: Two-year assessment of the efficacy and safety of sitagliptin in elderly patients with type 2 diabetes: Post hoc analysis of the ASSET-K study.
abstract: BACKGROUND
  There have only been a few reports about use of dipeptidyl peptidase 4 (DPP-4) inhibitors in elderly patients with type 2 diabetes mellitus (T2DM), suggesting that the safety of these agents has not been sufficiently demonstrated. We performed a comparative review of the efficacy and safety of sitagliptin for Japanese patients with T2DM managed in the real-world clinical setting.
  
  
  METHODS
  An age-stratified analysis was performed of 831 patients who were treated with sitagliptin for 2 years. Parameters assessed included the hemoglobin A1c (HbA1c), body weight, serum creatinine, and adverse events. HbA1c and the incidence of hypoglycemia were also evaluated in patients treated with sitagliptin and a sulfonylurea (SU), who were divided into three age groups (<65 years, 65-74 years, and ≥75 years).
  
  
  RESULTS
  Comparison of glycemic control parameters, laboratory values, and adverse events revealed significant improvement of HbA1c, casual postprandial plasma glucose, and fasting plasma glucose in each age group with no change in body weight. Serum creatinine increased significantly in all age groups. Hypoglycemia only occurred in patients who received combined treatment with an SU and sitagliptin, and there was no age-related difference in its incidence.
  
  
  CONCLUSIONS
  HbA1c was improved by 2 years of sitagliptin therapy in all three age groups, and age did not seem to influence the incidence of hypoglycemic events. These results confirm the efficacy and safety of sitagliptin in patients ≥ 75 years old, suggesting that it is also useful for treating elderly patients with T2DM.
authors.affiliation: Study Group of the Diabetes Committee, Kanagawa Physicians Association, Yokohama, Japan. umecli@mta.biglobe.ne.jp.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Umezawa
authors.affiliation: Study Group of the Diabetes Committee, Kanagawa Physicians Association, Yokohama, Japan. kubota@sj8.so-net.ne.jp.
authors.forename: Akira
authors.initials: A
authors.lastname: Kubota
authors.affiliation: Study Group of the Diabetes Committee, Kanagawa Physicians Association, Yokohama, Japan. nrcbd536@ybb.ne.jp.
authors.forename: Hajime
authors.initials: H
authors.lastname: Maeda
authors.affiliation: Study Group of the Diabetes Committee, Kanagawa Physicians Association, Yokohama, Japan. rankana@kanamori-cl.jp.
authors.forename: Akira
authors.initials: A
authors.lastname: Kanamori
authors.affiliation: Study Group of the Diabetes Committee, Kanagawa Physicians Association, Yokohama, Japan. matoba-clinic@po1.dti2.ne.jp.
authors.forename: Kiyokazu
authors.initials: K
authors.lastname: Matoba
authors.affiliation: Study Group of the Diabetes Committee, Kanagawa Physicians Association, Yokohama, Japan. jin-clinic@nifty.com.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Jin
authors.affiliation: Study Group of the Diabetes Committee, Kanagawa Physicians Association, Yokohama, Japan. fminagawa-endo@umin.ac.jp.
authors.forename: Fuyuki
authors.initials: F
authors.lastname: Minagawa
authors.affiliation: Study Group of the Diabetes Committee, Kanagawa Physicians Association, Yokohama, Japan. UIH45876@nifty.com.
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Obana
authors.affiliation: Study Group of the Diabetes Committee, Kanagawa Physicians Association, Yokohama, Japan. e36m3kotaro@nifty.com.
authors.forename: Kotaro
authors.initials: K
authors.lastname: Iemitsu
authors.affiliation: Study Group of the Diabetes Committee, Kanagawa Physicians Association, Yokohama, Japan. sksym-1404@nifty.com.
authors.forename: Shogo
authors.initials: S
authors.lastname: Ito
authors.affiliation: Study Group of the Diabetes Committee, Kanagawa Physicians Association, Yokohama, Japan. QYF11710@nifty.com.
authors.forename: Hikaru
authors.initials: H
authors.lastname: Amamiya
authors.affiliation: Study Group of the Diabetes Committee, Kanagawa Physicians Association, Yokohama, Japan. kaneshiro-diabetes-c@jcom.home.ne.jp.
authors.forename: Mizuki
authors.initials: M
authors.lastname: Kaneshiro
authors.affiliation: Study Group of the Diabetes Committee, Kanagawa Physicians Association, Yokohama, Japan. markune@ka2.so-net.ne.jp.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Takai
authors.affiliation: Study Group of the Diabetes Committee, Kanagawa Physicians Association, Yokohama, Japan. kaneshi@rf6.so-net.ne.jp.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Kaneshige
authors.affiliation: Study Group of the Diabetes Committee, Kanagawa Physicians Association, Yokohama, Japan. hoshinocl@pure.ocn.ne.jp.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Hoshino
authors.affiliation: Study Group of the Diabetes Committee, Kanagawa Physicians Association, Yokohama, Japan. miya1@space.ocn.ne.jp.
authors.forename: Masashi
authors.initials: M
authors.lastname: Ishikawa
authors.affiliation: Study Group of the Diabetes Committee, Kanagawa Physicians Association, Yokohama, Japan. nminami@gmail.com.
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Minami
authors.affiliation: Study Group of the Diabetes Committee, Kanagawa Physicians Association, Yokohama, Japan. mjob9949-mnet@yahoo.co.jp.
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Takuma
authors.affiliation: Study Group of the Diabetes Committee, Kanagawa Physicians Association, Yokohama, Japan. nsasai@d3.dion.ne.jp.
authors.forename: Nobuo
authors.initials: N
authors.lastname: Sasai
authors.affiliation: Study Group of the Diabetes Committee, Kanagawa Physicians Association, Yokohama, Japan. kmyajp@yahoo.co.jp.
authors.forename: Sachio
authors.initials: S
authors.lastname: Aoyagi
authors.affiliation: Study Group of the Diabetes Committee, Kanagawa Physicians Association, Yokohama, Japan. t2kawata@marianna-u.ac.jp.
authors.forename: Takehiro
authors.initials: T
authors.lastname: Kawata
authors.affiliation: Study Group of the Diabetes Committee, Kanagawa Physicians Association, Yokohama, Japan. mokubo@mokubo-clinic.jp.
authors.forename: Atsuko
authors.initials: A
authors.lastname: Mokubo
authors.affiliation: Study Group of the Diabetes Committee, Kanagawa Physicians Association, Yokohama, Japan. miyairinaka@feel.ocn.ne.jp.
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Miyairi
authors.affiliation: Study Group of the Diabetes Committee, Kanagawa Physicians Association, Yokohama, Japan. h_takeda@ka2.so-net.ne.jp.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takeda
authors.affiliation: Study Group of the Diabetes Committee, Kanagawa Physicians Association, Yokohama, Japan. s.honda@silverwing.jp.
authors.forename: Shin
authors.initials: S
authors.lastname: Honda
authors.affiliation: Study Group of the Diabetes Committee, Kanagawa Physicians Association, Yokohama, Japan. qq3966cd@etude.ocn.ne.jp.
authors.forename: Hideo
authors.initials: H
authors.lastname: Machimura
authors.affiliation: Study Group of the Diabetes Committee, Kanagawa Physicians Association, Yokohama, Japan. moto-cli@za2.so-net.ne.jp.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Motomiya
authors.affiliation: Study Group of the Diabetes Committee, Kanagawa Physicians Association, Yokohama, Japan. inaho474@ab.auone-net.jp.
authors.forename: Manabu
authors.initials: M
authors.lastname: Waseda
authors.affiliation: Study Group of the Diabetes Committee, Kanagawa Physicians Association, Yokohama, Japan. naka@tomei.or.jp.
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Naka
authors.affiliation: Division of Metabolism and Endocrinology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan. y2tanaka@marianna-u.ac.jp.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Tanaka
authors.affiliation: Department of Endocrinology and Diabetes, Yokohama City University Medical Center, Yokohama, Japan. terauchi@yokohama-cu.ac.jp.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Terauchi
authors.affiliation: Study Group of the Diabetes Committee, Kanagawa Physicians Association, Yokohama, Japan. ikuro@matsuba-web.com.
authors.forename: Ikuro
authors.initials: I
authors.lastname: Matsuba
mesh_terms: D000368:Aged; D015331:Cohort Studies; D003404:Creatinine / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000378:metabolism; D054873:Dipeptidyl-Peptidase IV Inhibitors / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007564:Japan; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D000068900:Sitagliptin Phosphate / Q000627:therapeutic use*; D013453:Sulfonylurea Compounds / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D003404:Creatinine; D054873:Dipeptidyl-Peptidase IV Inhibitors; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D000068900:Sitagliptin Phosphate; D013453:Sulfonylurea Compounds; C517652:hemoglobin A1c protein, human