Belgium; Diabetes Mellitus, Type 2/drug therapy/physiopathology; Dipeptidyl-Peptidase IV Inhibitors/adverse effects/pharmacology/therapeutic use; Dose-Response Relationship, Drug; Drug Combinations; Humans; Hypoglycemic Agents/adverse effects/pharmacology/therapeutic use; Metformin/adverse effects/pharmacology/therapeutic use; Pyrazines/adverse effects/pharmacology/therapeutic use; Renal Insufficiency/physiopathology; Triazoles/adverse effects/pharmacology/therapeutic use
Abstract :
[en] Sitagliptin (Januvia) was the first selective inhibitor of dipeptidyl peptidase-4 commercialized for the management of type 2 diabetes. It is also available as a fixed-dose combination with meformin (Janumet). Almost 5 years after its launch in Belgium, the present review summarizes the most recent data regarding the clinical efficacy of this antidiabetic agent, the controversy about its safety profile, its use at lower dosage in case of moderate to severe renal insufficiency, the various indications that have been successively accepted and reimbursed, and, finally, the perspectives offered by a large ongoing cardiovascular outcome trial (TECOS). [fr] Résumé : La sitagliptine (Januvia®) a été le premier inhibiteur
sélectif de la dipeptidyl peptidase-4 commercialisé pour le
traitement du diabète de type 2. Elle est également disponible
en combinaison fixe avec la metformine (Janumet®). Quelque
5 années après sa commercialisation en Belgique, cette revue
fait le point sur les dernières données disponibles concernant
l’efficacité clinique de cet antidiabétique oral, la controverse à
propos de son profil de sécurité, son utilisation à dose réduite
en présence d’une insuffisance rénale modérée à sévère, les
différentes indications successivement reconnues et remboursées,
et, enfin, les perspectives offertes par la grande étude de
prévention cardio-vasculaire actuellement en cours (TECOS).
Mots-clés : Diabète de type 2 - Incrétine - Inhibiteur de la
dipeptidyl peptidase-4 - Insuffisance rénale - Metformine -
Sitagliptine
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