Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Dec 15, 2021; 12(12): 2087-2095
Published online Dec 15, 2021. doi: 10.4239/wjd.v12.i12.2087
Efficacy of omarigliptin, once-weekly dipeptidyl peptidase-4 inhibitor, in patients with type 2 diabetes
Eiji Kawasaki, Yuko Nakano, Takahiro Fukuyama, Aira Uchida, Yoko Sagara, Hidekazu Tamai, Masayuki Tojikubo, Yuji Hiromatsu, Nobuhiko Koga
Eiji Kawasaki, Yuko Nakano, Takahiro Fukuyama, Aira Uchida, Yoko Sagara, Hidekazu Tamai, Masayuki Tojikubo, Yuji Hiromatsu, Nobuhiko Koga, Department of Diabetes and Endocrinology, Shin-Koga Hospital, Kurume 830-8577, Japan
Author contributions: Kawasaki E designed and performed the research and wrote the manuscript; Kawasaki E contributed to the conception, design of the work, analysis, and interpretation of data for the work; Nakano Y contributed to the analysis and interpretation of data for the work; Fukuyama T, Uchida A, Sagara Y, Tamai H, Tojikubo M, Hiromatsu Y, and Koga N contributed to the interpretation of data for the work; All authors have read and approved the final manuscript.
Institutional review board statement: This study’s protocol has been reviewed and approved by the ethics committee of Shin-Koga hospital.
Informed consent statement: To collected the retrospective data patients did not provide their verbal or written informed consent to join the study but were instead allowed to refuse participation according to the Japanese Ethical Guidelines for Medical and Health Research Involving Human Subjects and the local Institutional Review Board Approval due to its retrospective nature. As for the continuous glucose monitoring study, all patients provided informed written consent prior to enrollment.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Eiji Kawasaki, MD, PhD, Director, Department of Diabetes and Endocrinology, Shin-Koga Hospital, 120 Tenjin-cho, Kurume 830-8577, Japan. e-kawasaki@tenjinkai.or.jp
Received: February 3, 2021
Peer-review started: February 3, 2021
First decision: August 19, 2021
Revised: September 1, 2021
Accepted: December 8, 2021
Article in press: December 8, 2021
Published online: December 15, 2021
Processing time: 316 Days and 1.3 Hours
Abstract
BACKGROUND

Omarigliptin is one of several once-weekly dipeptidyl peptidase-4 inhibitors (DPP-4is). Despite the high frequency of switching from various daily DPP-4is to omarigliptin in actual clinical practice, data regarding its efficacy in patients with type 2 diabetes (T2D) after switching are limited.

AIM

To analyze the efficacy of omarigliptin in Japanese patients with T2D who had previously received treatment with other glucose-lowering agents.

METHODS

Forty-nine T2D patients treated for the first time with omarigliptin were recruited retrospectively and divided into four groups defined as either add-on or switched from daily DPP-4is: switched from linagliptin, switched from sitagliptin, and switched from vildagliptin. During a 3-mo follow-up, the clinical parameters among these groups were assessed and compared, with the impact of the switch on glycemic variability as measured by continuous glucose monitoring also being evaluated in the switched groups.

RESULTS

Hemoglobin A1c levels saw a significant decrease of -0.32% ± 0.41% in the add-on group (P = 0.002). However, the other groups’ variables depended on the pre-switch daily DPP-4i: switched from linagliptin, -0.05% ± 0.22%; switched from sitagliptin, -0.17% ± 0.33%; and switched from vildagliptin, 0.45% ± 0.42%, which saw significant worsening (P = 0.0007). Multivariate logistic regression analysis revealed that switching from vildagliptin to omarigliptin was independently associated with worsening glycemic control (P = 0.0013). The mean and standard deviation of sensor glucose value, the mean amplitude of glycemic excursions, and the mean of daily difference significantly improved when switching the patient from either linagliptin or sitagliptin to omarigliptin. However, in patients switched from vildagliptin, not only did the glucose variability indices see no improvements, the mean of daily difference even underwent significant worsening.

CONCLUSION

Administering omarigliptin as add-on therapy or switching to it from sitagliptin and linagliptin, but not vildagliptin, improves glycemic control and thus should help in decision making when selecting DPP-4is for T2D patients.

Keywords: Omarigliptin; Once-weekly dipeptidyl peptidase-4 inhibitor; Real-world practice; Retrospective study; Type 2 diabetes

Core Tip: This paper reported on the efficacy of omarigliptin in Japanese patients with type 2 diabetes who had previously received treatment with other glucose-lowering agents. The present study demonstrated that administering omarigliptin as add-on therapy or switching to it from sitagliptin and linagliptin, but not vildagliptin, provides more effective glycemic control. Ultimately, these findings should help decision-making in the actual clinical setting when selecting and using dipeptidyl peptidase-4 inhibitors in patients with type 2 diabetes.