Experts highlight vildagliptin’s novel mechanism of action

MANILA, Philippines - With their novel mechanism of action, DPP-4 inhibitors such as vildagliptin are an excellent addition to currently available oral treatments for type 2 diabetes.

This was the key message of local diabetes experts who spoke during the “Efficacy You Can See” Diabetes Summit organized by Novartis Healthcare Philippines in One Esplanade, Pasay City recently.

The summit was attended by about 800 local specialists in internal medicine, diabetology, endocrinology, cardiology, and nephrology. 

“By enhancing the body’s natural ability to control blood sugar, DPP-4 inhibitors correct the key defects in type 2 diabetes,” said Dr. Ruby Go, past president of the Philippine Society of Endocrinology and Metabolism (PSEM).

“Newer oral anti-diabetes agents such as DPP-4 inhibitors cover much more than their predecessors. DPP-4 inhibitors such as vildagliptin stimulate the release of insulin from the pancreas while inhibiting the release of glucose from the liver. They also mitigate insulin resistance and protect the insulin-producing beta cells of the pancreas,” said Dr. Araceli Panelo, who chairs the board of the Institute for Studies on Diabetes Foundation Inc.

“Numerous clinical studies have demonstrated the efficacy of vildagliptin, either as monotherapy or in combination with other diabetes therapies,” said Dr. Cynthia Halili-Manabat, PSEM past president.

A product of research-based Swiss healthcare company Novartis, vildagliptin is indicated for the treatment of type 2 diabetes as monotherapy and in combination with metformin, a sulfonylurea, a thiazolidinedione or insulin.

Its safety and efficacy profile has been established in a comprehensive clinical trial program that (as of 2008) included more than 22,000 type 2 diabetes patients.

Vildagliptin is approved in more than 100 countries across Europe, Asia Pacific (including the Philippines), Africa, and Latin America.

Manabat presented the results of major clinical studies on vildagliptin, including the EDGE study, one of the largest observational studies ever conducted in type 2 diabetes.

EDGE, which stands for Effectiveness of Diabetes control with vildaGliptin and vildagliptin/mEtformin, was a 12-month study involving 45,000 patients in 27 countries across five regions (East Asia, Europe, India, Latin America, and the Middle East). Five hundred patients from the Philippines participated in the study.

“The EDGE study showed that vildagliptin provided significant reduction in HbA1c both as monotherapy and in combination with other diabetes therapies. It also demonstrated that vildagliptin poses low risk of hypoglycemia and cardiovascular events,” said Manabat.

According to Manabat, vildagliptin may be prescribed to newly diagnosed patients as monotherapy or as initial combination therapy with metformin or as add-on to metformin.

Patients well-controlled on a sulfonylurea (e.g. glipizide, glimepiride) but who experience weight gain or hypoglycemia and those well-controlled on a thiazolidinedione (e.g. pioglitazone) but who experience weight gain or edema may consider switching to vildagliptin.

Vildagliptin may also be an add-on to insulin, and is indicated for elderly patients and patients with mild to moderate or severe kidney impairment.

“The EDGE study provides patients and physicians with real-world evidence of the effectiveness of vildagliptin,” said Thomas Weigold, country president and managing director of Novartis Healthcare Philippines.

“The results of EDGE are consistent with the safety and efficacy profile established in vildagliptin’s robust clinical trial program,” Weigold added.