Expert opinion on the prescription practice of vildagliptin and its combinations in managing type 2 diabetes mellitus in Indian settings

Authors

  • Manjula S. Department of Medical Services, Micro Labs Limited, Bangalore, Karnataka, India
  • Krishna Kumar M. Department of Medical Services, Micro Labs Limited, Bangalore, Karnataka, India

DOI:

https://doi.org/10.18203/2349-3933.ijam20241628

Keywords:

Type 2 diabetes mellitus, Glycemic control, Vildagliptin, Dapagliflozin, Metformin

Abstract

Background: The aim of the study was to gather expert opinion regarding the use of vildagliptin and its combinations in T2DM in Indian settings.

Methods: This cross-sectional study involved 24 questions and collected perspectives of experts across various clinical settings in India regarding the use of vildagliptin and its combinations for the management of type 2 diabetes mellitus (T2DM) in their clinical practice.

Results: Among 195 participants, most clinicians (73%) advocated vildagliptin once-daily formulation for newly diagnosed young diabetics, elderly patients with long-standing diabetes, and those with uncontrolled diabetes as an add-on therapy. Around 92% favored vildagliptin for its weight-neutral nature, preservation of beta-cell function, minimal glycemic variation, and low risk of adverse effects. Most clinicians (66%) preferred initiating vildagliptin and metformin combination therapy in diabetic individuals aged 40 to 50 years, with 53% opting for it when HbA1c levels exceeded 8%. Approximately 83% favored this combination for young, elderly, and long-standing diabetic individuals. More than half (54%) of the clinicians preferred prescribing the fixed-dose combination (FDC) of vildagliptin and dapagliflozin to 11-25% of the patients.  

Conclusions: The survey underscored the effectiveness of vildagliptin and its combinations in managing T2DM. Clinicians widely endorsed vildagliptin once-daily formulation and vildagliptin and metformin therapy for diverse diabetic populations due to their efficacy and tolerability. They also advocated the use of vildagliptin and dapagliflozin therapy, especially in patients with specific comorbidities or higher HbA1c levels, citing its benefits in achieving better glycemic control and reducing disease progression.

 

References

Sun H, Saeedi P, Karuranga S, Pinkepank M, Ogurtsova K, Duncan BB, et al. IDF Diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Res Clin Pract. 2022 Jan;183:109119. Erratum in: Diabetes Res Clin Pract. 2023 Oct;204:110945.

IDF Diabetes Atlas. Diabetes around the world in 2021, 2021. Available at: https://diabetesatlas.org/. Accessed on 20 April 2024.

Pradeepa R, Mohan V. Epidemiology of type 2 diabetes in India. Indian J Ophthalmol. 2021;69(11):2932-8.

Magliano DJ, Boyko EJ, IDF Diabetes Atlas 10th edition scientific committee. IDF diabetes atlas. 10th ed. Brussels: International Diabetes Federation; 2021.

Deacon CF, Holst JJ. Dipeptidyl peptidase-4 inhibitors for the treatment of type 2 diabetes: comparison, efficacy and safety. Expert Opin Pharmacother. 2013;14(15):2047-58.

Hasnani D, Chavda V, Agrawal D, Patni B, David A, Gathe S, et al. Validation of RSSDI therapeutic wheel with clinical experience of Indian physicians. Int J Diabetes Dev Ctries. 2022;42(3):451-8.

Kalra S, Zargar AH, Sridhar GR, Das AK, Ahmed J, Mohan JC, et al. Expert eValuation of Efficacy and Rationality of Vildagliptin “EVER-Vilda”: An Indian Perspective. Clin Med Insights Endocrinol Diab. 2024;17:11795514231203912.

Mathieu C, Degrande E. Vildagliptin: a new oral treatment for type 2 diabetes mellitus. Vasc Health Risk Manag. 2008;4(6):1349-60.

Bosi E, Camisasca RP, Collober C, Rochotte E, Garber AJ. Effects of vildagliptin on glucose control over 24 weeks in patients with type 2 diabetes inadequately controlled with metformin. Diabetes Care. 2007;30(4):890-5.

Kanazawa I, Tanaka KI, Notsu M, Tanaka S, Kiyohara N, Koike S, et al. Long-term efficacy and safety of vildagliptin add-on therapy in type 2 diabetes mellitus with insulin treatment. Diabetes Res Clin Pract. 2017;123:9-17.

Fonseca V, Schweizer A, Albrecht D, Baron MA, Chang I, Dejager S. Addition of vildagliptin to insulin improves glycaemic control in type 2 diabetes. Diabetologia. 2007;50(6):1148-55.

Bekiari E, Rizava C, Athanasiadou E, et al. Systematic review and meta-analysis of vildagliptin for treatment of type 2 diabetes. Endocrine. 2016;52(3):458-80.

Lauster CD, McKaveney TP, Muench SV. Vildagliptin: a novel oral therapy for type 2 diabetes mellitus. Am J Health Syst Pharm. 2007;64(12):1265-73.

Pan C, Wang X. Profile of vildagliptin in type 2 diabetes: efficacy, safety, and patient acceptability. Ther Clin Risk Manag. 2013;9:247-57.

Ding Y, Liu Y, Qu Y, Lin M, Dong F, Cao L, et al. Efficacy and safety of combination therapy with vildagliptin and metformin vs. metformin monotherapy for Type 2 Diabetes Mellitus therapy: a meta-analysis. Eur Rev Med Pharmacol Sci. 2022;26(8):2802-17.

Suh S, Song SO, Kim JH, Cho H, Lee WJ, Lee BW. Effectiveness of Vildagliptin in Clinical Practice: Pooled Analysis of Three Korean Observational Studies (the VICTORY Study). J Diabetes Res. 2017;2017:5282343.

Gaal L, Hermans MP, Daci E, Denhaerynch K, Meester LD, MacDonald K, et al. Effectiveness and Tolerability of Vildagliptin and the Single Pill Combination of Vildagliptin and Metformin in "Real-World" Management of Type 2 Diabetes Mellitus: The G-FORCE Study. Diabetes Ther. 2019;10(3):965-79.

Matthews DR, Paldánius PM, Proot P, Chiang YT, Stumvoll M, Prato SD, et al. Glycaemic durability of an early combination therapy with vildagliptin and metformin versus sequential metformin monotherapy in newly diagnosed type 2 diabetes (VERIFY): a 5-year, multicentre, randomised, double-blind trial. Lancet. 2019;394(10208):1519-29.

Mohan V, Zargar A, Chawla M, Joshi A, Ayyagari , Sethi B, Gaurav K, et al. Efficacy of a Combination of Metformin and Vildagliptin in Comparison to Metformin Alone in Type 2 Diabetes Mellitus: A Multicentre, Retrospective, Real-World Evidence Study. Diabetes Metab Syndr Obes. 2021;14:2925-33.

Garg U, Agrawala D, Akbar D, Biswas K, Modhugu D, Warrier D, et al. The Use of Vildagliptin-Dapagliflozin Fixed Dose Combination in Different Patient Profiles in Indian Settings: An Opinion-Based Consensus. Int J Current Sci Res Rev. 2023;6(3):2010-7.

Chao EC. Dapagliflozin: an evidence-based review of its potential in the treatment of type-2 diabetes. Core Evid. 2012;7:21-8.

Baker C, Retzik-Stahr C, Singh V, Plomondon R, Anderson V, Rasouli N. Should metformin remain the first-line therapy for treatment of type 2 diabetes? Ther Adv Endocrinol Metab. 2021;12:2042018820980225.

Downloads

Published

2024-06-25

Issue

Section

Original Research Articles