Efficacy and tolerability of vildagliptin as first line treatment in patients with diabetes type 2 in an outpatient setting

Abstract

Background: Inhibitors of dipeptidyl-peptidase IV are recommended as second-line therapy in type 2 diabetes (DT2), but data, as a first-line treatment in everyday clinical practice are scarce. To address this issue we conducted a 12-month, clinical study in an outpatient setting, using vildagliptin as the first-line treatment. Methods: Ninety-one drug naïve patients with DT2 started with vildagliptin monotherapy (100mg daily) for 4months and were scheduled to regular 4-monthly visits for 1year. Patients received add-on treatment with metformin or metformin and glimepiride according to their glycosylated hemoglobin (HbA1c) at each study-visit. Results: HbA1c was significantly decreased with vildagliptin monotherapy from 8.16% ± 1.60 to 7.52% ± 1.60, p < 0.001. Only 39% of the patients achieved the target of HbA1c ≤ 7.0% at the end of the 4th month. Mean change in HbA1c was significantly correlated with baseline HbA1c values (r = -0.51, p < 0.001). At the end of the study only 35% of the patients remained on vildagliptin monotherapy while the rest required add-on treatment with metformin or metformin and sulfonylurea. Conclusions: Vildagliptin is well tolerated either as monotherapy or in combination but the majority of patients require add-on therapy shortly after the beginning of treatment.