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Background <p>Given the complex nature of type 2 diabetes (T2D), monotherapy often fails to maintain long-term glycemic control, when combination therapy using multiple medications with complementary mechanisms of action comes to the rescue. Among the various treatment options, dipeptidyl peptidase-4 (DPP-4) inhibitors like vildagliptin and newer agents like imeglimin have shown promise.</p> Objective <p>The present study evaluated and compared the safety and effectiveness of imeglimin and vildagliptin as add-on therapies in T2D</p> Methods <p>This retrospective cohort study included patients with HbA1c levels 7.5–8.5% at the time of initiating the add-on therapy (with either vildagliptin 100&#xa0;mg (once daily) or imeglimin 1 gm (twice daily)) for at least 6&#xa0;months. Demographic details, medical history, baseline and follow-up values glycemic, hepatic, and renal measures were noted, along with the incidence of reported adverse reactions.</p> Results <p>With comparable baseline metrics, the study showed a significant reduction in FPG by 34.51&#xa0;mg/dL from baseline for the imeglimin group, as compared to 26.21&#xa0;mg/dL for the vildagliptin group. A mean reduction of 46.31&#xa0;mg/dL in PPPG was noted in the imeglimin group as compared to 29&#xa0;mg/dL for the vildagliptin group. A reduction of 0.98% HbA1C was noted in imeglimin add-ons as compared to 0.59% in vildagliptin add-ons. A significant decrease in SGOT and SGPT was also noted. Comparable safety profile was noted for both groups with the incidence of ADRs being 5.71% and 4.58% for imeglimin and vildagliptin, respectively.</p> Conclusion <p>Imeglimin and vildagliptin are both effective and safe add-on therapies for managing T2DM. While imeglimin may offer some advantages in terms of β-cell preservation and insulin sensitivity, the choice between these two agents should be individualized based on patient characteristics, preferences, and clinical response.</p>

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Comparing the safety and effectiveness of imeglimin and vildagliptin as add-on therapies in type 2 diabetes patients: A record-based study

  • 期刊论文

  • 发表日期：

    2025年2月1日

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  • Shambo Samrat Samajdar,
  • Rutul Gokalani,
  • Kaushik Biswas,
  • Bharat Saboo,
  • Shatavisa Mukherjee,
  • Jyotirmoy Pal,
  • Shashank Joshi

摘要

Background

Given the complex nature of type 2 diabetes (T2D), monotherapy often fails to maintain long-term glycemic control, when combination therapy using multiple medications with complementary mechanisms of action comes to the rescue. Among the various treatment options, dipeptidyl peptidase-4 (DPP-4) inhibitors like vildagliptin and newer agents like imeglimin have shown promise.

Objective

The present study evaluated and compared the safety and effectiveness of imeglimin and vildagliptin as add-on therapies in T2D

Methods

This retrospective cohort study included patients with HbA1c levels 7.5–8.5% at the time of initiating the add-on therapy (with either vildagliptin 100 mg (once daily) or imeglimin 1 gm (twice daily)) for at least 6 months. Demographic details, medical history, baseline and follow-up values glycemic, hepatic, and renal measures were noted, along with the incidence of reported adverse reactions.

Results

With comparable baseline metrics, the study showed a significant reduction in FPG by 34.51 mg/dL from baseline for the imeglimin group, as compared to 26.21 mg/dL for the vildagliptin group. A mean reduction of 46.31 mg/dL in PPPG was noted in the imeglimin group as compared to 29 mg/dL for the vildagliptin group. A reduction of 0.98% HbA1C was noted in imeglimin add-ons as compared to 0.59% in vildagliptin add-ons. A significant decrease in SGOT and SGPT was also noted. Comparable safety profile was noted for both groups with the incidence of ADRs being 5.71% and 4.58% for imeglimin and vildagliptin, respectively.

Conclusion

Imeglimin and vildagliptin are both effective and safe add-on therapies for managing T2DM. While imeglimin may offer some advantages in terms of β-cell preservation and insulin sensitivity, the choice between these two agents should be individualized based on patient characteristics, preferences, and clinical response.