DPP-4 inhibitors - Revision history

ClaireLewis at 18:43, 22 September 2019

2019-09-22T18:43:50Z

← Older revision		Revision as of 18:43, 22 September 2019
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	\| Januvia \|\| sitagliptin		\| Januvia \|\| sitagliptin
	\|-		\|-
	\| Janumet \|\| sitagliptin, metformin		\| Janumet \|\| sitagliptin, [[metformin]]
	\|-		\|-
	\| Janumet XR \|\| sitagliptin, metformin ER		\| Janumet XR \|\| sitagliptin, [[metformin]] ER
	\|-		\|-
	\| Onglyza \|\| saxagliptin		\| Onglyza \|\| saxagliptin
	\|-		\|-
	\| Kombiglyze XR \|\| saxagliptin, metformin ER		\| Kombiglyze XR \|\| saxagliptin, [[metformin]] ER
	\|-		\|-
	\| Tradjenta \|\| linagliptin		\| Tradjenta \|\| linagliptin
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	\| Glyxambi \|\| linagliptin, empagliflozin		\| Glyxambi \|\| linagliptin, empagliflozin
	\|-		\|-
	\| Jentadueto \|\| linagiptin, metformin		\| Jentadueto \|\| linagiptin, [[metformin]]
	\|-		\|-
	\| Nesina \|\| alogliptin		\| Nesina \|\| alogliptin
	\|-		\|-
	\| Kazano \|\| alogliptin, metformin		\| Kazano \|\| alogliptin, [[metformin]]
	\|-		\|-
	\| Oseni \|\| alogliptin, pioglitazone		\| Oseni \|\| alogliptin, pioglitazone
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	==Mechanism of Action==		==Mechanism of Action==
	DPP-4 ~~inhibitors inhibit the~~ enzyme ~~DPP-4, which is~~ expressed on ~~the~~ surface of most cell types. DPP-4 ~~deactivates~~ other bioactive peptides, including incretins ~~like~~ glucagon-like peptide-1 (GLP-1). GLP-1 is secreted ~~in the small intestines~~ in response to nutrients, stimulating glucose-dependent insulin release from ~~the~~ pancreatic beta-cells, which ~~then decrease~~ blood sugar levels. ~~Additionally, it~~ decreases gastric emptying and inhibits postprandial glucagon release.		*Inhibit DPP-4, an enzyme expressed on surface of most cell types
			*DPP-4 deacctivates other bioactive peptides, including incretins such as glucagon-like peptide-1 (GLP-1).
			*GLP-1 is secreted in response to nutrients, stimulating glucose-dependent insulin release from pancreatic beta-cells, which in turn decreases blood sugar levels.
			*Also decreases gastric emptying and inhibits postprandial glucagon release

	==Adverse Effects==		==Adverse Effects==
	In controlled ~~clinical~~ studies of sitagliptin as monotherapy and combination therapy, ~~the~~ overall incidence of adverse reactions ~~and the~~ discontinuation ~~of therapy in those taking sitagliptin was~~ similar to ~~that in those taking the~~ placebo~~. The most~~ commonly reported adverse reactions include ~~'''~~nasopharyngitis~~'''~~, ~~'''upper respiratory tract infection''' and '''headache'''.~~		*In controlled studies of sitagliptin (as monotherapy and combination therapy), overall incidence of adverse reactions/discontinuation similar to placebo
			*Most commonly reported adverse reactions include nasopharyngitis, URI, HA
	Postmarketing surveillance found an association ~~between those taking~~ sitagliptin and development of ~~'''~~acute pancreatitis~~''', though confounding~~ variables ~~include risk factors~~ such as diabetes, hypercholesterolemia, hypertriglyceridemia ~~and~~ obesity~~. Approximately 3 months after sitigliptin initiation, there were also~~ reports of ~~'''~~serious allergic reactions~~'''~~ including anaphylactoid reactions, angioedema ~~and exfoliate dermatologic reactions such as Stevens-Johnson syndrome.~~		*Postmarketing surveillance found association with sitagliptin and development of acute [[pancreatitis]]
			**Confounding variables such as diabetes, hypercholesterolemia, hypertriglyceridemia, obesity
	Studies of other drugs in this class additionally report lymphopenia, cough, peripheral edema, transaminitis, and hypertension.		*Also postmarketing reports of serious allergic reactions (including anaphylactoid reactions, angioedema, SJS)
			*Studies of other drugs in this class additionally report lymphopenia, cough, peripheral edema, transaminitis, and hypertension.
	~~Patients~~ taking ~~DPP-4 inhibitors have also been found to develop '''~~joint pain~~''', which often ceased within a month of discontinuation of the medication.~~		*Other side effects reported in patients taking this class of medication include joint pain

	==See Also==		==See Also==
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	[[Category:Pharmacology]]		[[Category:Pharmacology]]
			[[Category:Endocrinology]]

Rossdonaldson1: /* References */

2017-01-18T13:21:57Z

References

← Older revision		Revision as of 13:21, 18 January 2017
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	Patients taking DPP-4 inhibitors have also been found to develop '''joint pain''', which often ceased within a month of discontinuation of the medication.		Patients taking DPP-4 inhibitors have also been found to develop '''joint pain''', which often ceased within a month of discontinuation of the medication.

			==See Also==
			*[[Diabetes medications]]

	==References==		==References==

Mholtz: Updated formatting - page will need further modification

2016-12-31T02:45:02Z

Updated formatting - page will need further modification

← Older revision		Revision as of 02:45, 31 December 2016
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	==~~= '''Introduction''' =~~==		==Background==
	Dipeptidyl Peptidase-4 Inhibitors (gliptans) are a class of oral hypoglycemics that block DPP-4. This leads to an increase in the activity of incretins, which inhibit glucagon release, which in turn increase insulin secretion and slow gastric emptying, ultimately decreasing blood glucose levels. These drugs are commonly used in the treatment of type 2 diabetes.		*Dipeptidyl Peptidase-4 Inhibitors (gliptans) are a class of oral hypoglycemics that block DPP-4. This leads to an increase in the activity of incretins, which inhibit glucagon release, which in turn increase insulin secretion and slow gastric emptying, ultimately decreasing blood glucose levels. These drugs are commonly used in the treatment of type 2 diabetes.
			*Generally used as second or third line treatment for type 2 diabetes mellitus. They may be used as monotherapy or combined therapy.

	=== ~~'''~~FDA Approved DPP-4 Inhibitors~~'''~~ ===		===FDA Approved DPP-4 Inhibitors===
	{\| class="wikitable"		{\| class="wikitable"
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	\|}		\|}

	==~~= '''~~Mechanism of Action~~''' =~~==		==Mechanism of Action==
	DPP-4 inhibitors inhibit the enzyme DPP-4, which is expressed on the surface of most cell types. DPP-4 deactivates other bioactive peptides, including incretins like glucagon-like peptide-1 (GLP-1). GLP-1 is secreted in the small intestines in response to nutrients, stimulating glucose-dependent insulin release from the pancreatic beta-cells, which then decrease blood sugar levels. Additionally, it decreases gastric emptying and inhibits postprandial glucagon release.		DPP-4 inhibitors inhibit the enzyme DPP-4, which is expressed on the surface of most cell types. DPP-4 deactivates other bioactive peptides, including incretins like glucagon-like peptide-1 (GLP-1). GLP-1 is secreted in the small intestines in response to nutrients, stimulating glucose-dependent insulin release from the pancreatic beta-cells, which then decrease blood sugar levels. Additionally, it decreases gastric emptying and inhibits postprandial glucagon release.

	==~~= '''Indications''' ===~~		==Adverse Effects==
	~~DPP-4 inhibitors are used as second or third line treatment for type 2 diabetes mellitus. They may be used as monotherapy or combined therapy.~~

	~~=== '''~~Adverse Effects~~''' =~~==
	In controlled clinical studies of sitagliptin as monotherapy and combination therapy, the overall incidence of adverse reactions and the discontinuation of therapy in those taking sitagliptin was similar to that in those taking the placebo. The most commonly reported adverse reactions include '''nasopharyngitis''', '''upper respiratory tract infection''' and '''headache'''.		In controlled clinical studies of sitagliptin as monotherapy and combination therapy, the overall incidence of adverse reactions and the discontinuation of therapy in those taking sitagliptin was similar to that in those taking the placebo. The most commonly reported adverse reactions include '''nasopharyngitis''', '''upper respiratory tract infection''' and '''headache'''.

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	Patients taking DPP-4 inhibitors have also been found to develop '''joint pain''', which often ceased within a month of discontinuation of the medication.		Patients taking DPP-4 inhibitors have also been found to develop '''joint pain''', which often ceased within a month of discontinuation of the medication.

	==~~= '''~~References~~''' =~~==		==References==
	~~Dicker, Dror. “Impact on glycemic control and cardiovascular risk factors.” Diabetes Care. Vol 34, Supplement 2. May 2011.~~		<references/>

	~~Dungan K, DeSantis A. “Dipeptidyl peptidase 4 (DPP-4) inhibitors for the treatment of type 2 diabetes mellitus.” UpToDate, 10/18~~/~~2016.~~

	~~US Food and Drug Administration. "FDA Drug Safety Communication~~: ~~FDA warns that DPP-4 inhibitors for type 2 diabetes may cause severe joint pain." FDA, 6/23/2016. http://www.fda.gov/Drugs/DrugSafety/ucm459579.htm~~		[[Category:Pharmacology]]

H KDHCD H: /* References */

2016-12-30T19:15:08Z

References

← Older revision		Revision as of 19:15, 30 December 2016
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	=== '''References''' ===		=== '''References''' ===
	Dicker, Dror. “Impact on glycemic control and cardiovascular risk factors.” Diabetes Care. Vol 34, Supplement 2. May 2011.		Dicker, Dror. “Impact on glycemic control and cardiovascular risk factors.” Diabetes Care. Vol 34, Supplement 2. May 2011.

			Dungan K, DeSantis A. “Dipeptidyl peptidase 4 (DPP-4) inhibitors for the treatment of type 2 diabetes mellitus.” UpToDate, 10/18/2016.

	US Food and Drug Administration. "FDA Drug Safety Communication: FDA warns that DPP-4 inhibitors for type 2 diabetes may cause severe joint pain." FDA, 6/23/2016. http://www.fda.gov/Drugs/DrugSafety/ucm459579.htm		US Food and Drug Administration. "FDA Drug Safety Communication: FDA warns that DPP-4 inhibitors for type 2 diabetes may cause severe joint pain." FDA, 6/23/2016. http://www.fda.gov/Drugs/DrugSafety/ucm459579.htm

H KDHCD H: /* Mechanism of Action */

2016-12-30T19:12:12Z

Mechanism of Action

← Older revision		Revision as of 19:12, 30 December 2016
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	=== '''Mechanism of Action''' ===		=== '''Mechanism of Action''' ===
	DPP-4 inhibitors inhibit the enzyme DPP-4, which is expressed on the surface of most cell types. DPP-4 deactivates other bioactive peptides, including incretins like glucagon-like peptide-1 (GLP-1). GLP-1 is secreted in the small intestines in response to nutrients, stimulating glucose-dependent insulin release from the pancreatic beta-cells. Additionally, it decreases gastric emptying and inhibits postprandial glucagon release.		DPP-4 inhibitors inhibit the enzyme DPP-4, which is expressed on the surface of most cell types. DPP-4 deactivates other bioactive peptides, including incretins like glucagon-like peptide-1 (GLP-1). GLP-1 is secreted in the small intestines in response to nutrients, stimulating glucose-dependent insulin release from the pancreatic beta-cells, which then decrease blood sugar levels. Additionally, it decreases gastric emptying and inhibits postprandial glucagon release.

	=== '''Indications''' ===		=== '''Indications''' ===

H KDHCD H: /* Mechanism of Action */

2016-12-30T19:11:26Z

Mechanism of Action

← Older revision		Revision as of 19:11, 30 December 2016
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	=== '''Mechanism of Action''' ===		=== '''Mechanism of Action''' ===
	DPP-4 inhibitors inhibit the enzyme DPP-4, which is expressed on the surface of most cell types. DPP-4 deactivates other bioactive peptides, including incretins like glucagon-like peptide-1 (GLP-1). GLP-1 is secreted in the small intestines in response to nutrients, stimulating glucose-dependent insulin release from the pancreatic ~~islets~~. Additionally, it decreases gastric emptying and inhibits postprandial glucagon release.		DPP-4 inhibitors inhibit the enzyme DPP-4, which is expressed on the surface of most cell types. DPP-4 deactivates other bioactive peptides, including incretins like glucagon-like peptide-1 (GLP-1). GLP-1 is secreted in the small intestines in response to nutrients, stimulating glucose-dependent insulin release from the pancreatic beta-cells. Additionally, it decreases gastric emptying and inhibits postprandial glucagon release.

	=== '''Indications''' ===		=== '''Indications''' ===

H KDHCD H: /* References */

2016-12-30T19:09:55Z

References

← Older revision		Revision as of 19:09, 30 December 2016
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	=== '''References''' ===		=== '''References''' ===
			Dicker, Dror. “Impact on glycemic control and cardiovascular risk factors.” Diabetes Care. Vol 34, Supplement 2. May 2011.

	US Food and Drug Administration. "FDA Drug Safety Communication: FDA warns that DPP-4 inhibitors for type 2 diabetes may cause severe joint pain." FDA, 6/23/2016. http://www.fda.gov/Drugs/DrugSafety/ucm459579.htm		US Food and Drug Administration. "FDA Drug Safety Communication: FDA warns that DPP-4 inhibitors for type 2 diabetes may cause severe joint pain." FDA, 6/23/2016. http://www.fda.gov/Drugs/DrugSafety/ucm459579.htm

H KDHCD H: /* Indications */

2016-12-30T19:09:09Z

Indications

← Older revision		Revision as of 19:09, 30 December 2016
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	=== '''Indications''' ===		=== '''Indications''' ===
			DPP-4 inhibitors are used as second or third line treatment for type 2 diabetes mellitus. They may be used as monotherapy or combined therapy.

	=== '''Adverse Effects''' ===		=== '''Adverse Effects''' ===

H KDHCD H: /* Adverse Effects */

2016-12-30T19:02:34Z

Adverse Effects

← Older revision		Revision as of 19:02, 30 December 2016
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	=== '''Adverse Effects''' ===		=== '''Adverse Effects''' ===
			In controlled clinical studies of sitagliptin as monotherapy and combination therapy, the overall incidence of adverse reactions and the discontinuation of therapy in those taking sitagliptin was similar to that in those taking the placebo. The most commonly reported adverse reactions include '''nasopharyngitis''', '''upper respiratory tract infection''' and '''headache'''.

			Postmarketing surveillance found an association between those taking sitagliptin and development of '''acute pancreatitis''', though confounding variables include risk factors such as diabetes, hypercholesterolemia, hypertriglyceridemia and obesity. Approximately 3 months after sitigliptin initiation, there were also reports of '''serious allergic reactions''' including anaphylactoid reactions, angioedema and exfoliate dermatologic reactions such as Stevens-Johnson syndrome.

			Studies of other drugs in this class additionally report lymphopenia, cough, peripheral edema, transaminitis, and hypertension.

			Patients taking DPP-4 inhibitors have also been found to develop '''joint pain''', which often ceased within a month of discontinuation of the medication.

	=== '''References''' ===		=== '''References''' ===
	US Food and Drug Administration. "FDA Drug Safety Communication: FDA warns that DPP-4 inhibitors for type 2 diabetes may cause severe joint pain." FDA, 6/23/2016. http://www.fda.gov/Drugs/DrugSafety/ucm459579.htm		US Food and Drug Administration. "FDA Drug Safety Communication: FDA warns that DPP-4 inhibitors for type 2 diabetes may cause severe joint pain." FDA, 6/23/2016. http://www.fda.gov/Drugs/DrugSafety/ucm459579.htm

H KDHCD H: /* Mechanism of Action */

2016-12-30T18:57:37Z

Mechanism of Action

← Older revision		Revision as of 18:57, 30 December 2016
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	=== '''Mechanism of Action''' ===		=== '''Mechanism of Action''' ===
	DPP-4 inhibitors inhibit the enzyme DPP-4, which is expressed on the surface of most cell types. ~~When activated,~~ DPP-4 deactivates other bioactive peptides, including incretins like glucagon-like peptide-1 (GLP-1). GLP-1 is secreted in the small intestines in response to nutrients, stimulating glucose-dependent insulin release from the pancreatic islets. Additionally, it decreases gastric emptying and inhibits postprandial glucagon release.		DPP-4 inhibitors inhibit the enzyme DPP-4, which is expressed on the surface of most cell types. DPP-4 deactivates other bioactive peptides, including incretins like glucagon-like peptide-1 (GLP-1). GLP-1 is secreted in the small intestines in response to nutrients, stimulating glucose-dependent insulin release from the pancreatic islets. Additionally, it decreases gastric emptying and inhibits postprandial glucagon release.

	=== '''Indications''' ===		=== '''Indications''' ===