A COMPARISON OF GLP-1 RECEPTOR AGONISTS AND DPP-4 INHIBITORS FOR THE TREATMENT OF DIABETES MELLITUS TYPE 2: A SYSTEMATIC REVIEW
Main Article Content
Keywords
Diabetes, GLP-1, DPP-4, Blood sugar, Receptor
Abstract
Introduction: Decisions on balancing use of GLP-1 receptor agonists or DPP-4 inhibitors depend on various factors like patient's own characteristics and choice, in addition to medical background. GLP- 1 receptor agonists and DPP-4 inhibitor are a class of medications that work on incretin system to normoglycemia.
Aims and Objectives: To compare the effectiveness of drugs for the treatment of type 2 diabetes: GLP-1 receptor agonists Vs DPP-4 inhibitors.
Methods: A search of the MEDLINE databases restricted to human clinical trials using the search terms 'GLP-1RA' or 'DPP-4 inhibitor' produced seven direct comparative studies and one post hoc analysis all comparing a GLP-1RA with sitagliptin. The effectiveness and safety of GLP-1RAs and DPP-4 inhibitors in T2D patients was assessed by use of a variety of tools including research studies, treatment algorithms, product prescribing information, and personal clinical experience.
Results: For GLP-1RAs, direct clinical trials showed superior control of blood sugar levels, weight reduction, and general drug approach compared to sitagliptin: the DPP-4 inhibitions through these medications, rarely, consumers experience side effects like nausea. However, with a proper education and threat, dosage increase could manage it, though. The nausea is momentarily. From a nutshell, the existing treatment guidelines make an increment over metformin medication with a switch to an incretin-based agent for further reducing the cardiovascular risk in those patients who are already on the treatment, but this use remains restricted in some countries.
Conclusion: GLP-1RAs give a better glucose control and weight loss in T2D than DPP-4 inhibitors. Alternatives are DPP-4 inhibitors instead of GLP-1RAs in situations of no prominent weight changes, when formulation by mouth is necessary or only well-tolerated GLP-1RAs are available.
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17. R. A. DeFronzo et al., “The Efficacy and Safety of Saxagliptin When Added to Metformin Therapy in Patients With Inadequately Controlled Type 2 Diabetes With Metformin Alone,” Diabetes Care, vol. 32, no. 9, pp. 1649–1655, Sep. 2009, doi: 10.2337/dc08-1984.
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19. J. Rosenstock, R. Brazg, P. J. Andryuk, K. Lu, and P. Stein, “Efficacy and safety of the dipeptidyl peptidase-4 inhibitor sitagliptin added to ongoing pioglitazone therapy in patients with type 2 diabetes: A 24-week, multicenter, randomized, double-blind, placebo-controlled, parallel-group study,” Clin. Ther., vol. 28, no. 10, pp. 1556–1568, Oct. 2006, doi: 10.1016/j.clinthera
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21. L. Kennedy and J. A. Davidson, “Advances in therapy for type 2 diabetes: GLP–1 receptor agonists and DPP–4 inhibitors,” Cleve. Clin. J. Med., vol. 76, no. 12 suppl 5, pp. S28–S38, Dec. 2009, doi: 10.3949/ccjm.76.s5.05.
22. J. Gerich, “DPP-4 inhibitors: What may be the clinical differentiators?,” Diabetes Res. Clin. Pract., vol. 90, no. 2, pp. 131–140, Nov. 2010, doi: 10.1016/j.diabres.2010.07.006.
23. R. A. DeFronzo, T. Okerson, P. Viswanathan, X. Guan, J. H. Holcombe, and L. MacConell, “Effects of exenatide versus sitagliptin on postprandial glucose, insulin and glucagon secretion, gastric emptying, and caloric intake: a randomized, cross-over study,” Curr. Med. Res. Opin., vol. 24, no. 10, pp. 2943–2952, Oct. 2008, doi: 10.1185/03007990802418851.
24. J. K. Berg, S. K. Shenouda, C. R. Heilmann, A. L. Gray, and J. H. Holcombe, “Effects of exenatide twice daily versus sitagliptin on 24‐h glucose, glucoregulatory and hormonal measures: a randomized, double‐blind, crossover study,” Diabetes, Obes. Metab., vol. 13, no. 11, pp. 982– 989, Nov. 2011, doi: 10.1111/j.1463-1326.2011.01428.x.
25. R. M. Bergenstal et al., “Efficacy and safety of exenatide once weekly versus sitagliptin or pioglitazone as an adjunct to metformin for treatment of type 2 diabetes (DURATION-2): a randomised trial,” Lancet, vol. 376, no. 9739, pp. 431–439, Aug. 2010, doi: 10.1016/S0140-
6736(10)60590-9.
26. C. Wysham et al., “DURATION‐2: efficacy and safety of switching from maximum daily
sitagliptin or pioglitazone to once‐weekly exenatide,” Diabet. Med., vol. 28, no. 6, pp. 705–714, Jun. 2011, doi: 10.1111/j.1464-5491.2011.03301.x.
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Feb 28, 2024
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Dr Rida Rizvi, Dr Ashutosh Roy, Dr Renju Ravi, & Dr Jyothi Vybhavi V S. (2024). A COMPARISON OF GLP-1 RECEPTOR AGONISTS AND DPP-4 INHIBITORS FOR THE TREATMENT OF DIABETES MELLITUS TYPE 2: A SYSTEMATIC REVIEW. Journal of Population Therapeutics and Clinical Pharmacology, 31(2), 2622–2635. https://doi.org/10.53555/jptcp.v31i2.4667
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Author Biographies
Dr Rida Rizvi
Junior Resident, Department of Clinical Pharmacology & Therapeutic Medicine, Baba Raghav Das Medical College, Gorakhpur, Uttar Pradesh, India
Dr Ashutosh Roy
Junior Resident, Department of Clinical Pharmacology & Therapeutic Medicine, Baba Raghav Das Medical College, Gorakhpur, Uttar Pradesh, India
Dr Renju Ravi
Assistant professor, Department of Clinical Pharmacology, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
Dr Jyothi Vybhavi V S
Associate Professor, Department of Physiology, Sri Chamundeshwari Medical College Hospital & Research Institute, Channapatna, Ramanagara District, Karnataka, India