skip to content
Dovepress - Open Access to Scientific and Medical Research
View our mobile site

8852

Weight neutrality with the DPP-4 inhibitor, vildagliptin: Mechanistic basis and clinical experience

Review

(2198) Views  (858) Full article downloads

Authors: James E Foley, Jens Jordan

Published Date July 2010 Volume 2010:6 Pages 541 - 548
DOI: http://dx.doi.org/10.2147/VHRM.S10952

James E Foley1, Jens Jordan2

1Clinical Research and Development, Novartis Pharmaceutical Corporation, East Hanover, New Jersey, USA; 2Institute for Clinical Pharmacology, Hannover Medical School, Hannover, Germany

Abstract: Various factors may confound how diabetes medications affect a patient’s weight. Agents that induce hypoglycemia may promote weight gain through “defensive eating”. Conversely, patients whose hyperglycemia exceeds the renal glucose threshold may overeat to compensate for calories lost in urine and so gain weight when drug therapy ablates glycosuria. Some drugs, such as thiazolidinediones, may promote weight gain via increased lipid storage. Glucagon-like peptide-1 receptor agonists increase satiety, delay gastric emptying, and generally produce weight loss. Dipeptidyl peptidase (DPP)-4 inhibitors are generally weight-neutral, although modest weight loss has been observed with the DPP-4 inhibitor, vildagliptin, in patients with relatively low baseline glycemia. The weight neutrality of vildagliptin likely results in part from its intrinsically low risk for hypoglycemia. Recent studies point to additional potential mechanisms. One study found that drug-naïve patients randomized to vildagliptin exhibited significantly lower chylomicron lipid and apolipoprotein levels than placebo patients, suggesting that vildagliptin may inhibit intestinal fat extraction. Another trial found that patients randomized to vildagliptin versus placebo experienced paradoxical postprandial increases in markers of fatty acid mobilization and oxidation, in conjunction with increased sympathetic stimulation. Elaboration of these and other pathways could further clarify the origins of the favorable weight profile of vildagriptin.

Keywords: DPP-4 inhibitor, type 2 diabetes mellitus, vildagliptin, weight






Readers of this article also read:

Role of aliskiren in cardio-renal protection and use in hypertensives with multiple risk factors
Inhibition of dipeptidyl peptidase-4: The mechanisms of action and clinical use of vildagliptin for the management of type 2 diabetes
Berberine: metabolic and cardiovascular effects in preclinical and clinical trials
An update on the treatment of type 1 and type 2 diabetes mellitus: focus on insulin detemir, a long-acting human insulin analog
Blood pressure-independent effect of candesartan on cardio-ankle vascular index in hypertensive patients with metabolic syndrome
Atherogenic dyslipidemia and diabetes mellitus: what’s new in the management arena?
COSEHC global vascular risk management quality improvement program: rationale and design
Assessing the general safety and tolerability of vildagliptin: value of pooled analyses from a large safety database versus evaluation of individual studies
Religion, spirituality, and older adults with HIV: critical personal and social resources for an aging epidemic
Cardiac ryanodine receptor in metabolic syndrome: is JTV519 (K201) future therapy?
  • Join ISVH

    Be part of the World's leading experts in vascular health by joining the International Society of Vascular Health (ISVH)

  • Testimonials

    "... I was impressed at the rapidity of publication from submission to final acceptance." Dr Edwin Thrower, PhD, Yale University