Combination therapy in type 2 diabetes mellitus: adding linagliptin to a stable regimen of metformin and a sulfonylurea

Abstract

Linagliptin, the most recently approved drug of the dipeptidyl peptidase-4 (DPP-4) inhibitor class, is an oral agent used to improve glycemic control in type 2 diabetes mellitus (T2DM). By inhibiting the DPP-4 enzyme, these drugs slow the inactivation of the endogenous incretin hormones glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), in turn reducing blood glucose levels in a glucose-dependent manner. As well as significantly reducing glycosylated hemoglobin, the class has a good safety profile, with a low incidence of hypoglycemia, and is not associated with weight gain. From a practical point of view, they also have simple regimens, generally with once-daily oral administration, and can be used as monotherapy or in combination with other anti-diabetic drugs. Owens and colleagues have reported a 6-month study of linagliptin add-on therapy in patients who were receiving a stable regimen of metformin and a sulfonylurea, but needed additional glycemic control. Linagliptin was associated with significant improvement in glycemic control and was well-tolerated by patients, indicating that it provides a valuable option for a large number of patients with T2DM, especially for those who would prefer to add an oral therapy to a current regimen.

Keywords::

• diabetes
• dipeptidyl peptidase-4 (DPP-4) inhibitor
• linagliptin
• metformin
• sulfonylurea

Declaration of interest

R Aronson has received speaker fees, honoraria and research grants from the following: Boehringer Ingelheim, Eli Lilly Canada, AstraZeneca and Bristol-Myers Squibb. Medical writing assistance was provided by Geraldine Thompson of Envision Scientific Solutions and was supported financially by Boehringer Ingelheim. Boehringer Ingelheim was given the opportunity to check the data used in the manuscript for factual accuracy only.

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