Indications for incretin-based therapies of type 2 diabetes: An evaluation of study populations, study design and effectiveness of exenatide and DPP-4 inhibitors in clinical studies

In order to evaluate the two novel incretin based therapies for the treatment of type 2 diabetes, DPP-4 inhibitors and the incretin mimetic exenatide, the clinical studies published to date have been reviewed. Since head-to-head comparisons are lacking, the clinical studies published to date for the DPP-4 inhibitors sitagliptin and vildagliptin and for exenatide have been evaluated with respect to study population, study design and effectiveness. DPP-4 inhibitors and exenatide both effectively lowered the HbA1c in the available studies. Although HbA1c reductions look similar at the first look, they need to be put into perspective considering the above mentioned comparative criteria. The following qualitative differences can be identified: exenatide remained effective in patients with a markedly longer diabetes duration and lead to a greater HbA1c reduction in this patient group, and exenatide has the additional effect of allowing weight loss.