Comparison of Vildagliptin and Pioglitazone in Korean Patients with Type 2 Diabetes Inadequately Controlled with Metformin.
BACKGROUND
We compared the efficacies of vildagliptin (50 mg twice daily) relative to pioglitazone (15 mg once daily) as an add-on treatment to metformin for reducing glycosylated hemoglobin (HbA1c) levels in Korean patients with type 2 diabetes.


METHODS
The present study was a multicenter, randomized, active-controlled investigation comparing the effects of vildagliptin and pioglitazone in Korean patients receiving a stable dose of metformin but exhibiting inadequate glycemic control. Each patient underwent a 16-week treatment period with either vildagliptin or pioglitazone as an add-on treatment to metformin.


RESULTS
The mean changes in HbA1c levels from baseline were -0.94% in the vildagliptin group and -0.6% in the pioglitazone group and the difference between the treatments was below the non-inferiority margin of 0.3%. The mean changes in postprandial plasma glucose (PPG) levels were -60.2 mg/dL in the vildagliptin group and -38.2 mg/dL in the pioglitazone group and these values significantly differed (P=0.040). There were significant decreases in the levels of total, low density lipoprotein, high density lipoprotein (HDL), and non-HDL cholesterol in the vildagliptin group but increases in the pioglitazone group. The mean change in body weight was -0.07 kg in the vildagliptin group and 0.69 kg in the pioglitazone group, which were also significantly different (P=0.002).


CONCLUSIONS
As an add-on to metformin, the efficacy of vildagliptin for the improvement of glycemic control is not inferior to that of pioglitazone in Korean patients with type 2 diabetes. In addition, add-on treatment with vildagliptin had beneficial effects on PPG levels, lipid profiles, and body weight compared to pioglitazone.
Department of Internal Medicine, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea.
Jong Ho
JH
Kim
Department of Internal Medicine, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea.
Sang Soo
SS
Kim
Department of Internal Medicine, Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju, Korea.
Hong Sun
HS
Baek
Department of Internal Medicine, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Korea.
In Kyu
IK
Lee
Department of Internal Medicine, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea.
Dong Jin
DJ
Chung
Department of Internal Medicine, Daegu Catholic University Medical Center, Catholic University of Daegu School of Medicine, Daegu, Korea.
Ho Sang
HS
Sohn
Department of Internal Medicine, Chosun University Hospital, Chosun University School of Medicine, Gwangju, Korea.
Hak Yeon
HY
Bae
Department of Internal Medicine, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea.
Mi Kyung
MK
Kim
Department of Internal Medicine, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.
Jeong Hyun
JH
Park
Department of Internal Medicine, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Korea.
Young Sik
YS
Choi
Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
Young Il
YI
Kim
Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea.
Jong Ryeal
JR
Hahm
Department of Internal Medicine, Busan St. Mary's Hospital, Catholic University of Pusan, Busan, Korea.
Chang Won
CW
Lee
Department of Internal Medicine, Changwon Fatima Hospital, Changwon, Korea.
Sung Rae
SR
Jo
Department of Internal Medicine, Dong-A Medical Center, Dong-A University College of Medicine, Busan, Korea.
Mi Kyung
MK
Park
Department of Internal Medicine, Daedong Hospital, Busan, Korea.
Kwang Jae
KJ
Lee
Department of Internal Medicine, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea. injkim@pusan.ac.kr.
In Joo
http://orcid.org/0000-0003-1307-6146
IJ
Kim
Dipeptidyl peptidase 4 inhibitor; Metformin; Thiazolidinediones