A randomized clinical trial of the efficacy and safety of sitagliptin as initial oral therapy in youth with type 2 diabetes

Shankar, R. Ravi and Zeitler, Philip and Deeb, Asma and Jalaludin, Muhammad Yazid and Garcia, Raymundo and Newfield, Ron S. and Samoilova, Yulia and Rosario, Carmen A. and Shehadeh, Naim and Saha, Chandan K. and Zhang, Yilong and Zilli, Martina and Scherer, Lynn W. and Lam, Raymond L. H. and Golm, Gregory T. and Engel, Samuel S. and Kaufman, Keith D. (2022) A randomized clinical trial of the efficacy and safety of sitagliptin as initial oral therapy in youth with type 2 diabetes. Pediatric Diabetes, 23 (2). pp. 173-182. ISSN 1399-543X, DOI https://doi.org/10.1111/pedi.13279.

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Abstract

To assess the efficacy and safety of DPP-4 inhibition with sitagliptin in youth with type 2 diabetes (T2D). Study Design This was a 54-week, double-blind, randomized, controlled clinical trial evaluating the safety and efficacy of DPP-4 inhibition with sitagliptin 100 mg once daily as initial oral therapy in youth with T2D. The 190 participants, aged 10-17 years, had HbA1c 6.5%-10% (7.0%-10% if on insulin). All were negative for pancreatic autoantibodies and overweight/obese at screening or diagnosis. The trial was placebo controlled for the first 20 weeks, after which metformin replaced placebo. The primary efficacy endpoint was change from baseline in HbA1c at Week 20. Results Treatment groups were well balanced at baseline (mean +/- SD HbA1c = 7.5% +/- 1.0, BMI percentile = 97.1% +/- 6.8, age = 14.0 years +/- 2.0 57.4% <15], 60.5% female). At Week 20, least squares mean changes from baseline in HbA1c were -0.01% (sitagliptin) and 0.18% (placebo); between-group difference (95% CI) = -0.19% (-0.68, 0.30), p = 0.448. At Week 54, the changes in HbA1c were 0.45% (sitagliptin) and -0.11 (placebo/metformin). There were no notable between-group differences in the adverse event profiles through Week 54. Conclusions DPP-4 inhibition with sitagliptin did not provide significant improvement in glycemic control. In this study, sitagliptin was generally well tolerated with a safety profile similar to that reported in adults. (ClinicalTrials.gov: NCT01485614; EudraCT: 2011-002528-42)

Item Type: Article
Funders: Merck & Company
Uncontrolled Keywords: Antihyperglycemic agents;Dipeptidyl peptidase-4 inhibitor; DPP-4;Incretin;Pediatric;Sitagliptin;Youth-onset type 2 diabetes
Subjects: R Medicine
R Medicine > RJ Pediatrics
Divisions: Faculty of Medicine
Depositing User: Ms. Juhaida Abd Rahim
Date Deposited: 28 Jul 2022 04:10
Last Modified: 28 Jul 2022 04:10
URI: http://eprints.um.edu.my/id/eprint/33637

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