Back to Journals » Vascular Health and Risk Management » Volume 6

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

Authors James E Foley, Jens Jordan

Published 1 July 2010 Volume 2010:6 Pages 541—548

DOI https://doi.org/10.2147/VHRM.S10952

Review by Single-blind

Peer reviewer comments 4

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

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF] 

 

Readers of this article also read:

Current perspectives in stem cell research for knee cartilage repair

Orth P, Rey-Rico A, Venkatesan JK, Madry H, Cucchiarini M

Stem Cells and Cloning: Advances and Applications 2014, 7:1-17

Published Date: 16 January 2014

A novel preparation method for silicone oil nanoemulsions and its application for coating hair with silicone

Hu Z, Liao M, Chen Y, Cai Y, Meng L, Liu Y, Lv N, Liu Z, Yuan W

International Journal of Nanomedicine 2012, 7:5719-5724

Published Date: 12 November 2012

Cross-linked acrylic hydrogel for the controlled delivery of hydrophobic drugs in cancer therapy

Deepa G, Thulasidasan AK, Anto RJ, Pillai JJ, Kumar GS

International Journal of Nanomedicine 2012, 7:4077-4088

Published Date: 27 July 2012

Biomarkers for osteoarthritis: investigation, identification, and prognosis

Zhai G, Aref Eshghi E

Current Biomarker Findings 2012, 2:19-28

Published Date: 29 June 2012

Topical diclofenac in the treatment of osteoarthritis of the knee

Niklas Schuelert, Fiona A Russell, Jason J McDougall

Orthopedic Research and Reviews 2011, 3:1-8

Published Date: 6 February 2011