Drug updated on 4/17/2024
| Dosage Form | Tablet (oral; 100 mg, 50 mg, 25 mg) |
| Drug Class | Dipeptidyl peptidase-4 inhibitors |
| Ongoing and Completed Studies | ClinicalTrials.gov |
Indication
- Indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.
Summary
- Sitagliptin (Januvia) is indicated as an adjunct to diet and exercise for improving glycemic control in adults with type 2 diabetes mellitus, showing efficacy particularly when combined with insulin in patients with latent autoimmune diabetes in adults (LADA), resulting in better glycemic control, improved islet β-cell function, fewer adverse events, and a lower incidence of hypoglycemia.
- The information was derived from 11 systematic reviews/meta-analyses focusing on the safety, efficacy, and comparison of sitagliptin with other anti-hyperglycemic agents.
- In obese/overweight type 2 diabetic patients aiming for pronounced weight loss and glycemic control, semaglutide might be a more effective option than sitagliptin; however, it may lead to an increased pulse rate along with a higher risk of total adverse events and treatment discontinuation.
- A network meta-analysis showed that sitagliptin had comparable rates of adverse events to placebo but highlighted gastrointestinal issues specifically associated with semaglutide use.
- When added to metformin therapy among uncontrolled diabetics previously using only metformin, sitagliptin demonstrated significant improvements, indicating its effectiveness as part of combination therapy.
- Data regarding the safety and efficacy of sitagliptin's usage post-kidney transplantation are currently limited, making it unclear if this drug can be confidently recommended for new-onset diabetes after transplantation, necessitating further research into this area.
- Among DPP4 inhibitors, including vildagliptin and linagliptin, which were found efficacious at reducing HbA1C levels and fasting plasma glucose (FPG), no notable difference was observed between them or against sitagliptin concerning risks related to hypoglycemia or upper respiratory tract infections.
- Special populations such as LADA patients could benefit from combining sitagliptin with insulin; however, more research is needed to understand its role in managing diabetes post-kidney transplantation due to currently insufficient evidence.
Product Monograph / Prescribing Information
| Document Title | Year | Source |
|---|---|---|
| Januvia (sitagliptin) Prescribing Information. | 2023 | Merck & Co. Inc., Rahway, NJ, USA |
Systematic Reviews / Meta-Analyses
Clinical Practice Guidelines
| Document Title | Year | Source |
|---|---|---|
| 2022 clinical practice guideline for development of a diabetes mellitus comprehensive care plan-2022 update. | 2022 | AACE Endocrine Practice |
| Pharmacologic glycemic management of type 2 diabetes in adults: 2020 update. | 2020 | Canadian Journal of Diabetes |
| Portuguese-Brazilian evidence-based guideline on the management of hyperglycemia in type 2 diabetes mellitus. | 2020 | Diabetology & Metabolic Syndrome |