Linagliptin rejected by the NHS in Wales for use in type 2 diabetes due to lack of evidence of efficacy

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We previously reported systematic reviews of DPP-4 inhibitors.  Recently, the All Wales Medicines Strategy Group, the government agency charged with assessing the effectiveness of medicines and making recommendations about their use in the NHS in Wales, issued an evaluation of linagliptin, a DPP-4 inhibitor marketed under the brand name Trajenta. Clinical question: In patients with [read the full story…]

No difference between TZDs and DPP-4 inhibitors or sulphonylureas added to metformin in type 2 diabetes

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Research question: In people with type 2 diabetes inadequately controlled with metformin, which additional oral therapy offers the greatest improvement in HbA1c? The reviewers just looked at glycaemic control in patients whose starting HbA1c was 7% or higher at 12 weeks or longer follow-up. The evidence: Eight randomised trials were found, which looked at various [read the full story…]

Possible adverse effects of DPP-4 inhibitors in type 2 diabetes

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DPP-4 inhibitors, or “gliptins”, are a new oral therapy for type 2 diabetes.  This review set out to find evidence for their safety in long term use. Clinical question: In type 2 diabetes, do DPP-4 inhibitors have any adverse effects? The evidence: The reviewers found 67 randomised controlled trials that evaluated alogliptin, linagliptin, saxagliptin, sitagliptin, [read the full story…]