Once-weekly oral antidiabetic agent and treatment satisfaction

Dear Editor,

We thank Doctors Takahara et al. for their Letter to the Editor in response to our recently published paper in this journal entitled “A randomized, double-blind, non-inferiority trial evaluating the efficacy and safety of omarigliptin, a once-weekly DPP-4 inhibitor, or glimepiride in patients with type 2 diabetes inadequately controlled on metformin monotherapy”¹. The phase 3 clinical program for omarigliptin demonstrated that it has a safety and efficacy profile similar to that of once-daily DPP-4 inhibitors, but because all subjects received both a once-weekly and a once-daily study drug to maintain blinding, these studies could not assess differences in patient satisfaction between a once-weekly and a once-daily drug. Real world clinical experience and data such as that reported by Takahara et al. will be important to elucidate the impact of a once-weekly oral diabetes medication on patient satisfaction.

In recent years, a patient-centered approach has been recommended for the treatment of type 2 diabetes². In keeping with this recommendation, omarigliptin was developed as a therapeutic option which might be preferred by some patients. Omarigliptin was not developed to be a substitute for daily DPP-4 inhibitors for all patients. In a cross-sectional online survey among patients with type 2 diabetes in Japan, where omarigliptin (Marizev^®1) is approved, 33.3% of the overall survey population and 45.7% of treatment-naïve patients stated that they preferred a once-weekly medication over a once-daily diabetes medication³. Thoughtful physician engagement aimed at understanding individual patient preferences and the barriers that may prevent a patient from achieving optimal glycemic control should help inform the selection of patients for whom the use of a once-weekly oral diabetes medication may offer a preferred treatment option.

Transparency

Declaration of funding

The original manuscript was supported by Merck & Co. Inc., Kenilworth, NJ, USA.

Declaration of financial/other relationships

From the original manuscript, it was declared that Y.H. has received research grants, consultant & speaker honoraria from Amarin, Amgen, AZ, BMS, BI, BI-Lilly, Eisai, Intarcia, Janssen, Lexicon, Lilly, Merck Pfizer, Novo Nordisk, Regeneron, and Sanofi. B.L., I.G., C.I., E.A.O’N., Z.W., S.S., K.D.K., S.S.E. and E.L. are employees of Merck Sharp & Dohme Corp., a subsidiary of Merck & Co. Inc., Kenilworth, NJ, who may own stock and/or hold stock options in the Company. CMRO peer reviewers on the original manuscript had no relevant financial or other relationships to disclose.

Acknowledgements

The original manuscript had editorial assistance provided by Jennifer Rotonda PhD and Michele McColgan BA of Merck & Co. Inc., Kenilworth, NJ. Trial registration numbers: Clinical Trials.gov: NCT01682759, EudraCT Number: 2012-002309-23.

Note

Notes

1 MARIZEV^® is omarigliptin (Merck & Co., Inc., Kenilworth, NJ, USA; MSD outside of USA and Canada), a once-weekly DPP-4 inhibitor for type 2 diabetes, approved in Japan.