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Published in: Diabetes Therapy 2/2018

Open Access 01-04-2018 | Original Research

Efficacy and Safety of Teneligliptin 40 mg in Type 2 Diabetes: A Pooled Analysis of Two Phase III Clinical Studies

Authors: Takashi Kadowaki, Kazuyo Sasaki, Manabu Ishii, Miyuki Matsukawa, Yoshiteru Ushirogawa

Published in: Diabetes Therapy | Issue 2/2018

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Abstract

Introduction

Teneligliptin, an antihyperglycemic agent belonging to the dipeptidyl peptidase-4 inhibitor class, is usually prescribed at a dose of 20 mg/day. In Japan, the dose can be increased to 40 mg/day if needed. We examined the treatment response when the teneligliptin dose was increased from 20 to 40 mg in a post hoc pooled analysis of data from two 52-week, open-label, phase III clinical trials of teneligliptin 20–40 mg/day as monotherapy or combination treatment in Japanese patients with type 2 diabetes.

Methods

In both studies, patients received teneligliptin 20 mg for at least 28 weeks; thereafter the dose was increased if glycemic control was inadequate. The data set for this post hoc analysis comprised those patients whose teneligliptin dose was increased to 40 mg at week 28 (N = 204). We assessed (i) the proportion of patients achieving HbA1c reduction after teneligliptin dose increase [≤ − 0.1% change in HbA1c during weeks 28–52 (24 weeks); responders] and (ii) the response to teneligliptin 40 mg according to whether or not patients experienced HbA1c re-elevation (≥ 0.1% increase) during 28 weeks of teneligliptin 20 mg.

Results

Of 204 patients, 108 (52.9%) showed a response to teneligliptin 40 mg (HbA1c change ≤ − 0.1% during weeks 28–52) and had mean (± SD) HbA1c reduction of 0.50 ± 0.44%. Of patients showing re-elevation of HbA1c during treatment with teneligliptin 20 mg, 89/143 (62.2%) achieved HbA1c reduction after dose increase to 40 mg. Logistic regression analyses suggested that change in body weight is one of the parameters linked to HbA1c reduction after dose increase to teneligliptin 40 mg. The incidence of adverse events was not changed after teneligliptin dose increase.

Conclusion

Increasing the dosage of teneligliptin from 20 to 40 mg/day has potential as a well-tolerated and effective option for treating type 2 diabetes.

Funding

Mitsubishi Tanabe Pharma Corporation.
Appendix
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Literature
3.
go back to reference Araki E, Haneda M, Kasuga M, et al. New glycemic targets for patients with diabetes from the Japan Diabetes Society. J Diabetes Investig. 2017;8(1):123–5.CrossRefPubMed Araki E, Haneda M, Kasuga M, et al. New glycemic targets for patients with diabetes from the Japan Diabetes Society. J Diabetes Investig. 2017;8(1):123–5.CrossRefPubMed
4.
go back to reference American Diabetes Association. Standards of medical care in diabetes—2018. Diabetes Care. 2018;40(Suppl 1):S1–159. American Diabetes Association. Standards of medical care in diabetes—2018. Diabetes Care. 2018;40(Suppl 1):S1–159.
5.
go back to reference Inzucchi SE, Bergenstal RM, Buse JB, et al. Management of hyperglycaemia in type 2 diabetes, 2015: a patient-centred approach. Update to a position statement of the American Diabetes Association and the European Association for the Study of diabetes. Diabetologia. 2015;58(3):429–42.CrossRefPubMed Inzucchi SE, Bergenstal RM, Buse JB, et al. Management of hyperglycaemia in type 2 diabetes, 2015: a patient-centred approach. Update to a position statement of the American Diabetes Association and the European Association for the Study of diabetes. Diabetologia. 2015;58(3):429–42.CrossRefPubMed
6.
go back to reference Yabe D, Seino Y, Fukushima M, Seino S. Beta cell dysfunction versus insulin resistance in the pathogenesis of type 2 diabetes in east asians. Curr Diab Rep. 2015;15(6):36.CrossRefPubMedCentral Yabe D, Seino Y, Fukushima M, Seino S. Beta cell dysfunction versus insulin resistance in the pathogenesis of type 2 diabetes in east asians. Curr Diab Rep. 2015;15(6):36.CrossRefPubMedCentral
7.
8.
go back to reference Deacon CF, Lebovitz HE. Comparative review of dipeptidyl peptidase-4 inhibitors and sulphonylureas. Diabetes Obes Metab. 2016;18(4):333–47.CrossRefPubMed Deacon CF, Lebovitz HE. Comparative review of dipeptidyl peptidase-4 inhibitors and sulphonylureas. Diabetes Obes Metab. 2016;18(4):333–47.CrossRefPubMed
9.
go back to reference Kim YG, Hahn S, Oh TJ, Kwak SH, Park KS, Cho YM. Differences in the glucose-lowering efficacy of dipeptidyl peptidase-4 inhibitors between Asians and non-Asians: a systematic review and meta-analysis. Diabetologia. 2013;56(4):696–708.CrossRefPubMed Kim YG, Hahn S, Oh TJ, Kwak SH, Park KS, Cho YM. Differences in the glucose-lowering efficacy of dipeptidyl peptidase-4 inhibitors between Asians and non-Asians: a systematic review and meta-analysis. Diabetologia. 2013;56(4):696–708.CrossRefPubMed
10.
go back to reference Tajiri Y, Tsuruta M, Ohki T, et al. Long-term efficacy of sitagliptin for the treatment of type 2 diabetic patients in Japan. Endocr J. 2012;59(3):197–204.CrossRefPubMed Tajiri Y, Tsuruta M, Ohki T, et al. Long-term efficacy of sitagliptin for the treatment of type 2 diabetic patients in Japan. Endocr J. 2012;59(3):197–204.CrossRefPubMed
11.
go back to reference Esposito K, Chiodini P, Maiorino MI, Bellastella G, Capuano A, Giugliano D. Glycaemic durability with dipeptidyl peptidase-4 inhibitors in type 2 diabetes: a systematic review and meta-analysis of long-term randomised controlled trials. BMJ Open. 2014;4(6):E005442.CrossRefPubMedPubMedCentral Esposito K, Chiodini P, Maiorino MI, Bellastella G, Capuano A, Giugliano D. Glycaemic durability with dipeptidyl peptidase-4 inhibitors in type 2 diabetes: a systematic review and meta-analysis of long-term randomised controlled trials. BMJ Open. 2014;4(6):E005442.CrossRefPubMedPubMedCentral
12.
go back to reference Kubota A, Yabe D, Kanamori A, et al. Factors influencing the durability of the glucose-lowering effect of sitagliptin combined with a sulfonylurea. J Diabetes Investig. 2014;5(4):445–8.CrossRefPubMedPubMedCentral Kubota A, Yabe D, Kanamori A, et al. Factors influencing the durability of the glucose-lowering effect of sitagliptin combined with a sulfonylurea. J Diabetes Investig. 2014;5(4):445–8.CrossRefPubMedPubMedCentral
13.
go back to reference Kanamori A, Matsuba I. Factors associated with reduced efficacy of sitagliptin therapy: analysis of 93 patients with type 2 diabetes treated for 1.5 years or longer. J Clin Med Res. 2013;5(3):217–21.PubMedPubMedCentral Kanamori A, Matsuba I. Factors associated with reduced efficacy of sitagliptin therapy: analysis of 93 patients with type 2 diabetes treated for 1.5 years or longer. J Clin Med Res. 2013;5(3):217–21.PubMedPubMedCentral
14.
go back to reference Yoshida T, Akahoshi F, Sakashita H, et al. Discovery and preclinical profile of teneligliptin (3-[(2S,4S)-4-[4-(3-methyl-1-phenyl-1H-pyrazol-5-yl)piperazin-1-yl]pyrrolidin-2-ylcarbonyl]thiazolidine): a highly potent, selective, long-lasting and orally active dipeptidyl peptidase iv inhibitor for the treatment of type 2 diabetes. Bioorg Med Chem. 2012;20(19):5705–19.CrossRefPubMed Yoshida T, Akahoshi F, Sakashita H, et al. Discovery and preclinical profile of teneligliptin (3-[(2S,4S)-4-[4-(3-methyl-1-phenyl-1H-pyrazol-5-yl)piperazin-1-yl]pyrrolidin-2-ylcarbonyl]thiazolidine): a highly potent, selective, long-lasting and orally active dipeptidyl peptidase iv inhibitor for the treatment of type 2 diabetes. Bioorg Med Chem. 2012;20(19):5705–19.CrossRefPubMed
15.
go back to reference Eto T, Inoue S, Kadowaki T. Effects of once-daily teneligliptin on 24-h blood glucose control and safety in Japanese patients with type 2 diabetes mellitus: a 4-week, randomized, double-blind, placebo-controlled trial. Diabetes Obes Metab. 2012;14(11):1040–6.CrossRefPubMed Eto T, Inoue S, Kadowaki T. Effects of once-daily teneligliptin on 24-h blood glucose control and safety in Japanese patients with type 2 diabetes mellitus: a 4-week, randomized, double-blind, placebo-controlled trial. Diabetes Obes Metab. 2012;14(11):1040–6.CrossRefPubMed
17.
go back to reference Kadowaki T, Kondo K. Efficacy and safety of teneligliptin in combination with pioglitazone in Japanese patients with type 2 diabetes mellitus. J Diabetes Investig. 2013;4(6):576–84.CrossRefPubMedPubMedCentral Kadowaki T, Kondo K. Efficacy and safety of teneligliptin in combination with pioglitazone in Japanese patients with type 2 diabetes mellitus. J Diabetes Investig. 2013;4(6):576–84.CrossRefPubMedPubMedCentral
18.
go back to reference Kadowaki T, Kondo K. Efficacy and safety of teneligliptin added to glimepiride in Japanese patients with type 2 diabetes mellitus: a randomized, double-blind, placebo-controlled study with an open-label, long-term extension. Diabetes Obes Metab. 2014;16(5):418–25.CrossRefPubMed Kadowaki T, Kondo K. Efficacy and safety of teneligliptin added to glimepiride in Japanese patients with type 2 diabetes mellitus: a randomized, double-blind, placebo-controlled study with an open-label, long-term extension. Diabetes Obes Metab. 2014;16(5):418–25.CrossRefPubMed
19.
go back to reference Kadowaki T, Inagaki N, Kondo K, et al. Efficacy and safety of teneligliptin added to canagliflozin monotherapy in Japanese patients with type 2 diabetes mellitus: A multicentre, randomized, double-blind, placebo-controlled, parallel-group comparative study. Diabetes Obes Metab. 2018;20(2):453–57.CrossRefPubMedPubMedCentral Kadowaki T, Inagaki N, Kondo K, et al. Efficacy and safety of teneligliptin added to canagliflozin monotherapy in Japanese patients with type 2 diabetes mellitus: A multicentre, randomized, double-blind, placebo-controlled, parallel-group comparative study. Diabetes Obes Metab. 2018;20(2):453–57.CrossRefPubMedPubMedCentral
20.
go back to reference Kadowaki T, Kondo K, Sasaki N, et al. Efficacy and safety of teneligliptin add-on to insulin monotherapy in Japanese patients with type 2 diabetes mellitus: a 16-week, randomized, double-blind, placebo-controlled trial with an open-label period. Expert Opin Pharmacother. 2017;18(13):1291–300.CrossRefPubMed Kadowaki T, Kondo K, Sasaki N, et al. Efficacy and safety of teneligliptin add-on to insulin monotherapy in Japanese patients with type 2 diabetes mellitus: a 16-week, randomized, double-blind, placebo-controlled trial with an open-label period. Expert Opin Pharmacother. 2017;18(13):1291–300.CrossRefPubMed
21.
go back to reference Kadowaki T, Kondo K. Efficacy, safety and dose-response relationship of teneligliptin, a dipeptidyl peptidase-4 inhibitor, in Japanese patients with type 2 diabetes mellitus. Diabetes Obes Metab. 2013;15(9):810–8.CrossRefPubMed Kadowaki T, Kondo K. Efficacy, safety and dose-response relationship of teneligliptin, a dipeptidyl peptidase-4 inhibitor, in Japanese patients with type 2 diabetes mellitus. Diabetes Obes Metab. 2013;15(9):810–8.CrossRefPubMed
22.
go back to reference Bryson A, Jennings PE, Deak L, Paveliu FS, Lawson M. The efficacy and safety of teneligliptin added to ongoing metformin monotherapy in patients with type 2 diabetes: a randomized study with open label extension. Expert Opin Pharmacother. 2016;17(10):1309–16.CrossRefPubMed Bryson A, Jennings PE, Deak L, Paveliu FS, Lawson M. The efficacy and safety of teneligliptin added to ongoing metformin monotherapy in patients with type 2 diabetes: a randomized study with open label extension. Expert Opin Pharmacother. 2016;17(10):1309–16.CrossRefPubMed
23.
go back to reference Abe I, Sugimoto K, Takeshita K, et al. Efficacy of high-dose teneligliptin, a dipeptidyl peptidase-4 inhibitor, for glycemic parameters in patients with type 2 diabetes estimated with continuous glucose monitoring: a pilot study. Integr Obesity Diabetes. 2017. https://doi.org/10.15761/IOD.1000176. Abe I, Sugimoto K, Takeshita K, et al. Efficacy of high-dose teneligliptin, a dipeptidyl peptidase-4 inhibitor, for glycemic parameters in patients with type 2 diabetes estimated with continuous glucose monitoring: a pilot study. Integr Obesity Diabetes. 2017. https://​doi.​org/​10.​15761/​IOD.​1000176.
24.
go back to reference Kadowaki T, Marubayashi F, Yokota S, Katoh M, Iijima H. Safety and efficacy of teneligliptin in Japanese patients with type 2 diabetes mellitus: a pooled analysis of two phase III clinical studies. Expert Opin Pharmacother. 2015;16(7):971–81.CrossRefPubMed Kadowaki T, Marubayashi F, Yokota S, Katoh M, Iijima H. Safety and efficacy of teneligliptin in Japanese patients with type 2 diabetes mellitus: a pooled analysis of two phase III clinical studies. Expert Opin Pharmacother. 2015;16(7):971–81.CrossRefPubMed
25.
go back to reference Chen XW, He ZX, Zhou ZW, et al. Clinical pharmacology of dipeptidyl peptidase 4 inhibitors indicated for the treatment of type 2 diabetes mellitus. Clin Exp Pharmacol Physiol. 2015;42(10):999–1024.CrossRefPubMed Chen XW, He ZX, Zhou ZW, et al. Clinical pharmacology of dipeptidyl peptidase 4 inhibitors indicated for the treatment of type 2 diabetes mellitus. Clin Exp Pharmacol Physiol. 2015;42(10):999–1024.CrossRefPubMed
26.
go back to reference Lamers D, Famulla S, Wronkowitz N, et al. Dipeptidyl peptidase 4 is a novel adipokine potentially linking obesity to the metabolic syndrome. Diabetes. 2011;60(7):1917–25.CrossRefPubMedPubMedCentral Lamers D, Famulla S, Wronkowitz N, et al. Dipeptidyl peptidase 4 is a novel adipokine potentially linking obesity to the metabolic syndrome. Diabetes. 2011;60(7):1917–25.CrossRefPubMedPubMedCentral
27.
go back to reference Aso Y, Ozeki N, Terasawa T, et al. Serum level of soluble CD26/dipeptidyl peptidase-4 (DPP-4) predicts the response to sitagliptin, a DPP-4 inhibitor, in patients with type 2 diabetes controlled inadequately by metformin and/or sulfonylurea. Transl Res. 2012;159(1):25–31.CrossRefPubMed Aso Y, Ozeki N, Terasawa T, et al. Serum level of soluble CD26/dipeptidyl peptidase-4 (DPP-4) predicts the response to sitagliptin, a DPP-4 inhibitor, in patients with type 2 diabetes controlled inadequately by metformin and/or sulfonylurea. Transl Res. 2012;159(1):25–31.CrossRefPubMed
28.
go back to reference Aso Y, Terasawa T, Kato K, et al. The serum level of soluble CD26/dipeptidyl peptidase 4 increases in response to acute hyperglycemia after an oral glucose load in healthy subjects: association with high-molecular weight adiponectin and hepatic enzymes. Transl Res. 2013;162(5):309–16.CrossRefPubMed Aso Y, Terasawa T, Kato K, et al. The serum level of soluble CD26/dipeptidyl peptidase 4 increases in response to acute hyperglycemia after an oral glucose load in healthy subjects: association with high-molecular weight adiponectin and hepatic enzymes. Transl Res. 2013;162(5):309–16.CrossRefPubMed
29.
go back to reference Konya H, Yano Y, Matsutani S, et al. Profile of saxagliptin in the treatment of type 2 diabetes: focus on Japanese patients. Ther Clin Risk Manag. 2014;10:547–58.CrossRefPubMedPubMedCentral Konya H, Yano Y, Matsutani S, et al. Profile of saxagliptin in the treatment of type 2 diabetes: focus on Japanese patients. Ther Clin Risk Manag. 2014;10:547–58.CrossRefPubMedPubMedCentral
30.
go back to reference Halabi A, Maatouk H, Siegler KE, Faisst N, Lufft V, Klause N. Pharmacokinetics of teneligliptin in subjects with renal impairment. Clin Pharmacol Drug Dev. 2013;2(3):246–54.CrossRefPubMed Halabi A, Maatouk H, Siegler KE, Faisst N, Lufft V, Klause N. Pharmacokinetics of teneligliptin in subjects with renal impairment. Clin Pharmacol Drug Dev. 2013;2(3):246–54.CrossRefPubMed
31.
go back to reference Sharma SK, Panneerselvam A, Singh KP, Parmar G, Gadge P, Swami OC. Teneligliptin in management of type 2 diabetes mellitus. Diabetes Metab Syndr Obes. 2016;9:251–60.CrossRefPubMedPubMedCentral Sharma SK, Panneerselvam A, Singh KP, Parmar G, Gadge P, Swami OC. Teneligliptin in management of type 2 diabetes mellitus. Diabetes Metab Syndr Obes. 2016;9:251–60.CrossRefPubMedPubMedCentral
32.
go back to reference Sohmiya M, Kanazawa I, Kato Y. Seasonal changes in body composition and blood HbA1c levels without weight change in male patients with type 2 diabetes treated with insulin. Diabetes Care. 2004;27(5):1238–9.CrossRefPubMed Sohmiya M, Kanazawa I, Kato Y. Seasonal changes in body composition and blood HbA1c levels without weight change in male patients with type 2 diabetes treated with insulin. Diabetes Care. 2004;27(5):1238–9.CrossRefPubMed
Metadata
Title
Efficacy and Safety of Teneligliptin 40 mg in Type 2 Diabetes: A Pooled Analysis of Two Phase III Clinical Studies
Authors
Takashi Kadowaki
Kazuyo Sasaki
Manabu Ishii
Miyuki Matsukawa
Yoshiteru Ushirogawa
Publication date
01-04-2018
Publisher
Springer Healthcare
Published in
Diabetes Therapy / Issue 2/2018
Print ISSN: 1869-6953
Electronic ISSN: 1869-6961
DOI
https://doi.org/10.1007/s13300-018-0372-x

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