Comparison of Vildagliptin and Pioglitazone in Korean Patients with Type 2 Diabetes Inadequately Controlled with Metformin

• Published in: Diabetes & metabolism journal Vol. 40; no. 3; pp. 230 - 239
• Main Authors: Kim, Jong Ho, Kim, Sang Soo, Baek, Hong Sun, Lee, In Kyu, Chung, Dong Jin, Sohn, Ho Sang, Bae, Hak Yeon, Kim, Mi Kyung, Park, Jeong Hyun, Choi, Young Sik, Kim, Young Il, Hahm, Jong Ryeal, Lee, Chang Won, Jo, Sung Rae, Park, Mi Kyung, Lee, Kwang Jae, Kim, In Joo
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Diabetes Association / Daehan Dangnyobyeong Hakoe 01.06.2016; Korean Diabetes Association; 대한당뇨병학회
• Subjects: Cholesterol; Diabetes; Dipeptidyl peptidase 4 inhibitor; Drug dosages; Females; Glucose; Heart failure; High density lipoprotein; Hypoglycemia; Insulin resistance; Metformin; Original; Patients; Thiazolidinediones; 내과학; Dipeptidyl peptidase 4 inhibitor; Thiazolidinediones; Metformin
• ISSN: 2233-6079; 2233-6087
• DOI: 10.4093/dmj.2016.40.3.230

We compared the efficacies of vildagliptin (50 mg twice daily) relative to pioglitazone (15 mg once daily) as an add-on treatment to metformin for reducing glycosylated hemoglobin (HbA1c) levels in Korean patients with type 2 diabetes. The present study was a multicenter, randomized, active-controlled investigation comparing the effects of vildagliptin and pioglitazone in Korean patients receiving a stable dose of metformin but exhibiting inadequate glycemic control. Each patient underwent a 16-week treatment period with either vildagliptin or pioglitazone as an add-on treatment to metformin. The mean changes in HbA1c levels from baseline were -0.94% in the vildagliptin group and -0.6% in the pioglitazone group and the difference between the treatments was below the non-inferiority margin of 0.3%. The mean changes in postprandial plasma glucose (PPG) levels were -60.2 mg/dL in the vildagliptin group and -38.2 mg/dL in the pioglitazone group and these values significantly differed (P=0.040). There were significant decreases in the levels of total, low density lipoprotein, high density lipoprotein (HDL), and non-HDL cholesterol in the vildagliptin group but increases in the pioglitazone group. The mean change in body weight was -0.07 kg in the vildagliptin group and 0.69 kg in the pioglitazone group, which were also significantly different (P=0.002). As an add-on to metformin, the efficacy of vildagliptin for the improvement of glycemic control is not inferior to that of pioglitazone in Korean patients with type 2 diabetes. In addition, add-on treatment with vildagliptin had beneficial effects on PPG levels, lipid profiles, and body weight compared to pioglitazone.