- Drug/Regimen
- Increasing Age Associated with Higher Dipeptidyl Peptidase-4 Inhibition Rate Is a Predictive Factor for Efficacy of Dipeptidyl Peptidase-4 Inhibitors
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Sangmo Hong, Chang Hee Jung, Song Han, Cheol-Young Park
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Diabetes Metab J. 2022;46(1):63-70. Published online April 19, 2021
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DOI: https://doi.org/10.4093/dmj.2020.0253
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 Graphical Abstract
 Abstract
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 - Background
It is not known which type 2 diabetes mellitus (T2DM) patients would most benefit from dipeptidyl peptidase-4 (DPP-4) inhibitor treatment. We aimed to investigate the predictors of response to DPP-4 inhibitors considering degree of DPP-4 inhibition.
Methods
This study is a post hoc analysis of a 24-week, randomized, double-blind, phase III trial that compared the efficacy and safety of a DPP-4 inhibitor (gemigliptin vs. sitagliptin) in patients with T2DM. Subjects were classified into tertiles of T1 <65.26%, T2=65.26%–76.35%, and T3 ≥76.35% by DPP-4 inhibition. We analyzed the change from baseline in glycosylated hemoglobin (HbA1c) according to DPP-4 inhibition with multiple linear regression adjusting for age, ethnicity, body mass index, baseline HbA1c, and DPP-4 activity at baseline.
Results
The mean age was greater in the high tertile group compared with the low tertile group (T1: 49.8±8.3 vs. T2: 53.1±10.5 vs. T3: 55.3±9.5, P<0.001) of DPP-4 inhibition. Although HbA1c at baseline was not different among tertiles of DPP-4 inhibition (P=0.398), HbA1c after 24-week treatment was lower in the higher tertile compares to the lower tertile (T1: 7.30%±0.88% vs. T2: 7.12%±0.78% vs. T3: 7.00%±0.78%, P=0.021). In multiple regression analysis, DPP-4 enzyme inhibition rate was not a significant determent for HbA1c reduction due to age. In subgroup analysis by tertile of DPP-4 inhibition, age was the only significant predictor and only in the highest tertile (R2=0.281, B=–0.014, P=0.024).
Conclusion
This study showed that HbA1c reduction by DPP-4 inhibitor was associated with increasing age, and this association was linked with higher DPP-4 inhibition.
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Citations
Citations to this article as recorded by  - Comparative efficacy and safety of sitagliptin or gliclazide combined with metformin in treatment-naive patients with type 2 diabetes: A single-center, prospective, randomized, controlled, noninferiority study with genetic polymorphism analysis
Min Qin, Lingxi Chao, Shiqun Liu
Medicine.2025; 104(2): e41061. CrossRef - Safety and efficacy of prusogliptin in type-2 diabetes mellitus: a systematic review and meta-analysis of randomized controlled trials
Abdul Moeed, Muhammad Ahmed Ali Fahim, Afia Salman, Tooba Saqib, Laiba Zafar, Hoorain Jamil, Alishba Adnan Janjua, Syed Muhammad Muneeb Akhtar, Hamna Ahmed Khan, Hajra Zainab Chaudry, Ayesha Ali, Laiba Sanober, Muqaddas Parvez, Hala Najeeb, Abdul Hannan S
Irish Journal of Medical Science (1971 -).2025;[Epub] CrossRef - Neurological Sequelae of Post-COVID-19 Fatigue: A Narrative Review of Dipeptidyl Peptidase IV-Mediated Cerebrovascular Complications
Che Mohd Nasril Che Mohd Nassir, Muhammad Danial Che Ramli, Usman Jaffer, Hafizah Abdul Hamid, Muhammad Zulfadli Mehat, Mazira Mohamad Ghazali, Ebrahim Nangarath Kottakal Cheriya
Current Issues in Molecular Biology.2024; 46(12): 13565. CrossRef
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