title: Distinct glucose-lowering properties in good responders treated with sitagliptin and alogliptin.
abstract: OBJECTIVE
  All dipeptidyl peptidase 4 (DPP-4) inhibitors display similar glycemic efficacies, although they differ greatly in their chemical structures and pharmacological properties. This may be due to the inclusions of non- or poor-responders in the analysis, thereby masking the real effects of these drugs. The aim of this study was to identify any differences in diabetic parameters only in good responders treated with sitagliptin and alogliptin.
  
  
  METHODS
  Treatment naïve subjects with type 2 diabetes mellitus were assigned to either sitagliptin 25-50 mg/day (n = 69) or alogliptin 12.5-25 mg/day monotherapy (n = 62) for 3 months. Only those who showed good response selected by a novel parameter called A1c index were further analysed (n = 24 for sitagliptin and n = 21 for alogliptin).
  
  
  RESULTS
  At baseline, FBG and BMI were significantly higher and CPR-index was significantly lower in alogliptin good responders. At 3 months, while similar reductions of HbA1c were observed in these two groups, decreases of fasting blood glucose (FBG) were significantly higher in alogliptin good responders. Homeostasis model assessment (HOMA)-R significantly decreased only in alogliptin good responders, while HOMA-B similarly and significantly increased in these two groups. BMI significantly increased only in sitagliptin good responders. Significant negative correlations were observed between A1c index and changes (Δ) of HOMA-B in both groups. By contrast, significant positive and negative correlations were observed between ΔFBG and ΔHOMA-R, and between ΔFBG and ΔHOMA-B, respectively, only in alogliptin good responders.
  
  
  CONCLUSIONS
  These results implicate that the effects on diabetic parameters and the glucose-lowering mechanisms of these two drugs might be different in those who have good response with these drugs. Accordingly, the choice of these drugs may be dependent on the characteristics of the patients.
authors.affiliation: Biomedial Center, Tokyo, Japan.|Division of Endocrinology and Metabolism, Department of Internal Medicine, Gyoda General Hospital, Saitama, Japan.
authors.forename: E
authors.initials: E
authors.lastname: Kutoh
authors.affiliation: Biomedial Center, Tokyo, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Hirate
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Gyoda General Hospital, Saitama, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Wada
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis* / Q000187:drug effects; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D054873:Dipeptidyl-Peptidase IV Inhibitors / Q000627:therapeutic use*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010880:Piperidines / Q000627:therapeutic use*; D000068900:Sitagliptin Phosphate / Q000627:therapeutic use*; D014498:Uracil / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D001786:Blood Glucose; D054873:Dipeptidyl-Peptidase IV Inhibitors; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D010880:Piperidines; D000068900:Sitagliptin Phosphate; D014498:Uracil; C520853:alogliptin