Use of vildagliptin from an internal disease specialist‘s point of view

Authors: R. Kožnarová
Published in: Vnitř Lék 2013; 59(4): 322-324
Category: Clinical praxis


Dipeptidyl peptidase 4 inhibitors (DPP‑ 4) are used as an oral hypoglycaemic agent in Type– 2 diabetic patients. From a clinical point of view the most important advantages of this preparation are improved diabetes compensation, significant reduction of hypoglycaemia risk compared with sulfonylurea derivatives, neutral weight profile and good GIT tolerance. Vildagliptin is a molecule from the group of DPP‑ 4 inhibitors which is recently used in internal outpatient care.

Key words:
diabetes mellitus –  hypoglycaemia –  safety –  vildagiptin


1. Holman RR., Paul SK, Bethel MA. 10‑year follow‑up of intensive glucose control in type 2 diabetes. N Engl J Med 2008; 359: 1577– 89.

2. Skyler JS, Bergenstal R, Bonow RO. Intensive glycemic control and the prevention of cardiovascular events: implications of the ACCORD, ADVANCE, and VA Diabetes Trials: a position statement of the American Diabetes Association and a Scientific Statement of the American College of Cardiology Foundation and the American Heart Association. Journal of the American College of Cardiology 2009; 53: 298– 304.

3. Drucker DJ, Sherman SI, Gorelick FS. Incretin‑based therapies for the treatment of type 2 diabetes: evaluation of the risks and benefits. Diab Care 2010; 33: 428– 33.

4. Haluzík M, Svačina Š. Inkretinová léčba diabetu. Praha: Mladá Fronta 2010.

5. Deacon CF. Dipeptidyl peptidase– 4 inhibitors in the treatment of type 2 diabetes: a comparative review. Diabetes Obes Metab 2011; 13: 7– 18.

6. Kožnarová R. Vildagliptin –  nový DPP‑ 4 inhibitor. Postrgrad Med 2009; 11(7): 356– 358.

7. Šmahelová A, Slíva J. Vildagliptin. Farmakoterapie 2009; 1: 29– 33.

8. Kožnarová R., Slíva J. Vildagiptin/ metformin, fixní léková kombinace. Farmakoterapie 2010; 6(1): 61– 65.

9. Abu– Hamdah R, Rabiee A, Meneilly GS. Clinical review: The extrapancreatic effects of glucagon‑like peptide– 1 and related peptides. J Clin Endocr Metab 2009; 94: 1843– 52.

10.Ahren B, Pacini G, Tura A, Foley JE, Schweizer A. Improved meal‑related insulin processing contributes to the enhancement of B– cell function by the DPP‑ 4 inhibitor vildagliptin in patients with type 2 diabetes. Horm Metab Res 2007; 39:826– 829.

11. Vella A, Bock G, Giesler PD et al. Effects of dipeptidyl peptidase– 4 inhibition on gastrointestinal function, meal appearance, and glucose metabolism in type 2 diabetes. Diabetes 2007; 56:1475– 1480

12. Baetta R, Corsini A. Pharmacology of dipeptidyl peptidase– 4 inhibitors: similarities and differences. Drugs 2011; 71: 1441– 67.

13. Scheen AJ. Pharmacokinetics of dipeptidylpeptidase– 4 inhibitors. Diabetes Obes Metab 2010;12(8):648– 658. Review.

14. Richard KR, Shelburne JS, Kirk JK. Tolerability of dipeptidyl peptidase– 4 inhibitors: a review. Clin Ther 2011; 33(11):1609– 1629.

15. Mari A, Sallas WM, He YL. Vildagliptin, a dipeptidyl peptidase– IV inhibitor, improves model– assessed beta‑cell function in patients with type 2 diabetes. J Clin Endocrinol Metab 2005; 90:4888– 4894.

16. Matthews DR, Dejager S, Ahren B, Fonseca V, Ferrannini E, Couturier A, Foley JE, Zinman B. Vildagliptin add- on to metformin produces similar efficacy and reduced hypoglycaemic risk compared with glimepiride, with no weight gain: results from a 2‑year study. Diabetes Obes Metab. 2010 Sep;12(9):780– 9.

17. Schweizer A. Assessing the cardio- cerebrovascular safety of vildagliptin: meta‑analysis of adjudicated events from a large Phase III type 2 diabetes population. Diabetes Obes Metab. 2010;12(6):485– 494.

18. Kvapil M. Porovnání klinické účinnosti inhibitorů DPP 4 sitagliptinu a vildagliptinu. Remedia 2009; 19(4): 273– 279.

19. Keating GM. Vildagliptin: a review of its use in type 2 diabetes mellitus. Drugs 2010; 70(16):2089– 2112.

20. Kothny W, Foley J, Kozlovski P, Shao Q, Gallwitz B, Lukashevich V. Improved glycaemic control with vildagliptin added to insulin, with or without metformin, in patients with type 2 diabetes mellitus. Diabetes Obes Metab 2013; 15(3):252– 7.

21. Haluzík M. Zkušenosti s vildagliptinem v terapii pacientů s diabetes mellitus 2. typu. Farmakoterapie 2012; 8(4): 426– 430.

22. Marfella R, Barbieri M, Grella R. Effects of vildagliptin twice daily v.s. sitagliptin once daily on 24– hour acute glucose fluctuation. J Diabetes Complications 2010; 24: 79– 83.

23. Monnier L, Colette C, Owens DR. Glyceamic variability: the third component of the dysglycemia in diabetes. Is it important? How to measure it? J Diab Sci Technol 2008; 2: 1094– 1100.

24. Kothny W, Shao Q, Groop PH, Lukashevich V. One‑year safety, tolerability and efficacy of vildagliptin in patients with type 2 diabetes and moderate or severe renal impairment. Diabetes Obes Metab. 2012; 14(11):1032– 9.

25. Ligueros– Saylan M, Foley J, Schweizer A, Couturier A, Kothny W. An assessment of adverse effects of vildagliptin versus comparators on the liver, the pankreas, the immune system, the skin and in patiens with impaired renal function from a large pooled database of Phase II a III clinical trials.Diabetes Obes Metab 2010;12: 495– 509.

26. Lukashevich V, Schweizer A, Shao Q, Groop PH, Kothny W. Safety and efficacy of vildagliptin versus placebo in patients with type 2 diabetes and moderate or severe renal impairment: a prospective 24‑week randomized placebo– controlled trial. Diab Obes Metab. 201; 13(10):947– 54.

27. Pratley RE. Management of type 2 diabetes in treatment- naive elderly patients: benefits and risks of vildagliptin monotherapy. Diab Care,2007; 30(12): 3017– 22.

28. Svačina Š. Vildagliptin/ metformin –  fixní kombinace. Remedia 2009; 19: 111– 114.

29. He YL, Flannery B, Campestrini J. Effect of food on the pharmacokinetics of a vildagliptin/ metformin (50/ 1000 mg) fixed‑dose combination tablet in healthy volunteers. Curr Med Res Opin 2008; 24:1703– 1709.

30. Schweizer A, Dejager S, Foley JE. Impact of insulin resistance, body mass index, disease duration, and duration of metformin use on the efficacy of vildagliptin. Diabetes Ther 2012; 3(1):8. Epub 2012 Jun 27.

31. Inzucchi SE, Bergenstal RM, Buse JB. Management of hyperglycemia in type 2 diabetes: A patient– centered approach: Position statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diab Care 2012; 35: 1364– 79.

32. Foley JE, Bunck MC, Möller– Goede DL, Poelma M, Nijpels G, Eekhoff EM, Schweizer A, Heine RJ, Diamant M. Beta cell function following 1 year vildagliptin or placebo treatment and after 12 week washout in drug‑naive patients with type 2 diabetes and mild. Diabetologia. 2011; 54(8):1985– 1991.

33. Schweizer A. Comparison between vildagliptin and metformin to sustain reductions in HbA1c over 1 year in drug‑naive patients with Type 2 diabetes. Diabet Med 2007; 955– 961.

34. Van Poppel PC et al. Vildagliptin improves endothelium– dependent vasodilatation in type 2 diabetes. Diab Care. 2011;34(9):2072– 7.

35. Fonseca VA. Ongoing clinical trials evaluating the cardiovascular safety and efficacy of therapeutic approaches to diabetes mellitus. The Amer J of Cardiol 2011; 108: 52B– 8B.

36. Duttaroy A, Voelker F, Zhang X. The DPP‑ 4 inhibitor vildagliptin increases b- cell mass in rodents. Diabetologia 2005; 48.

Diabetology Endocrinology Internal medicine

Article was published in

Internal Medicine

Issue 4

2013 Issue 4

Most read in this issue

This topic is also in:

Forgotten password

Don‘t have an account?  Create new account

Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.


Don‘t have an account?  Create new account