title: Dipeptidyl peptidase-4 inhibitors as preferable oral hypoglycemic agents in terms of treatment satisfaction: Results from a multicenter, 12-week, open label, randomized controlled study in Japan (PREFERENCE 4 study).
abstract: OBJECTIVE
  To compare the treatment satisfaction of four classes of oral hypoglycemic agents (OHAs): dipeptidyl peptidase-4 (DPP-4) inhibitors, α-glucosidase inhibitors (αGI), biguanides (BG) and sulfonylureas (SU), which are common initial treatments for type 2 diabetes mellitus patients in Japan, and to identify the best oral hypoglycemic agent in terms of treatment satisfaction.
  
  
  METHODS
  In this 12-week, randomized, controlled, open-label study, Japanese outpatients with type 2 diabetes mellitus who were naïve to pharmacological treatment were randomly assigned a DPP-4 inhibitor, a BG., an αGI or a SU. The primary end-point was the Oral Hypoglycemic Agent Questionnaire (OHA-Q) total and subscale scores (treatment convenience, somatic symptoms and satisfaction) at week 4. Adherence, glycated hemoglobin (HbA1c) level and safety were also evaluated.
  
  
  RESULTS
  The DPP-4 inhibitor group scored highest in the OHA-Q total and all subscale scores at week 4. The total score was significantly higher in the DPP-4 inhibitor group than in the BG or αGI groups (P = 0.0084 and 0.0147, respectively). The mean total score at week 12 was also highest in the DPP-4 inhibitor group, with a significant difference compared with the αGI group (P = 0.0293). The mean HbA1c decreased from baseline to week 12 in all groups. The DPP-4 inhibitor group had the highest adherence at weeks 4 and 12. A total of 11 patients reported adverse events, including one hypoglycemic event in the SU group.
  
  
  CONCLUSIONS
  The DPP-4 inhibitor was the most preferable option in terms of treatment satisfaction.
authors.affiliation: Department of Diabetology, Nara Medical University, Kashihara, Nara, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Ishii
authors.affiliation: Department of Endocrinology, Tenri Hospital, Tenri, Nara, Japan.
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Hayashino
authors.affiliation: Department of Diabetology, Nara Medical University, Kashihara, Nara, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Akai
authors.affiliation: Department of Diabetes Medicine, Nara City Hospital, Nara, Japan.
authors.forename: Matahiro
authors.initials: M
authors.lastname: Yabuta
authors.affiliation: Department of Endocrinology, Tenri Hospital, Tenri, Nara, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Tsujii
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D054873:Dipeptidyl-Peptidase IV Inhibitors / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D007564:Japan; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D054873:Dipeptidyl-Peptidase IV Inhibitors; D007004:Hypoglycemic Agents
keywords: Oral hypoglycemic agents; Randomized controlled study; Treatment satisfaction