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Advances in Therapy

, Volume 26, Issue 3, pp 249–262 | Cite as

Saxagliptin: a new DPP-4 inhibitor for the treatment of type 2 diabetes mellitus

  • Abd A. Tahrani
  • Milan K. Piya
  • Anthony H. Barnett
Review

Abstract

Type 2 diabetes mellitus (T2DM) is a global epidemic with increasing impact on individuals and healthcare providers. Available treatments (such as metformin, sulfonylureas, glitazones, and insulin) have proven unsatisfactory in producing a long-lasting impact on glycemic control. In addition, most of these treatments have undesirable side effects such as weight gain and hypoglycemia. As a result, exploring new treatment targets and new therapies is mandatory in order to treat this condition. The incretin pathway, in particular glucagon-like peptide (GLP-1), plays an important pathological role in the development of T2DM, and treatments targeting the incretin system have recently become available. These can mainly be divided into two broad categories; GLP-1 agonists/analogs (exenatide, liraglutide), and dipeptidyl peptidase-4 (DPP-4; the enzyme responsible for rapid inactivation of incretins) inhibitors (sitagliptin, vildagliptin). Saxagliptin is a novel DPP-4 inhibitor that has recently completed phase 3 studies. Saxagliptin is a potent and specific inhibitor of DPP-4 (in comparison with other dipeptidyl peptidase enzymes) that is given once daily. Current data suggest that saxagliptin as monotherapy or in combination with metformin, glyburide, or a glitazone results in significant reductions in fasting and postprandial plasma glucose and hemoglobin A1c (HbA1c). Saxagliptin is well tolerated and does not increase hypoglycemia compared with the placebo, and is probably weight neutral. Saxagliptin will be a new effective drug in the currently available variety of antidiabetic medications for patients with T2DM.

Keywords

DPP-4 GLP-1 hypoglycemia incretin saxagliptin sitagliptin type 2 diabetes mellitus vildagliptin 

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Copyright information

© Springer Healthcare Communications 2009

Authors and Affiliations

  • Abd A. Tahrani
    • 1
  • Milan K. Piya
    • 2
    • 3
  • Anthony H. Barnett
    • 2
    • 3
  1. 1.Undergraduate CenterBirmingham Heartlands HospitalBirminghamUK
  2. 2.School of Experimental and Clinical Medicine, College of Medical and Dental SciencesUniversity of BirminghamBirminghamUK
  3. 3.The Biomedical Unit and Department of Diabetes and EndocrinologyHeart of England NHS Foundation Trust (Teaching)BirminghamUK

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