The Medical Letter on Drugs and Therapeutics
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Saxagliptin (Onglyza) for Type 2 Diabetes

Saxagliptin (Onglyza– Bristol-Myers Squibb), the second oral dipeptidyl peptidase-4 (DPP-4) inhibitor to be marketed in the US, has been approved by the FDA for treatment of adults with type 2 diabetes. Sitagliptin (Januvia) was the first.1

MECHANISM OF ACTION — Saxagliptin inhibits the activity of DPP-4, an enzyme that inactivates and degrades incretin hormones, cytokines and other peptides. Released in response to meals, incretin hormones potentiate insulin release and decrease glucagon production, lowering serum glucose concentrations.

CLINICAL STUDIES — Treatment-Naïve Patients – A double-blind, randomized, placebo-controlled, 24-week trial in 401 patients with type 2 diabetes not adequately controlled by diet and exercise (HbA1c 7-10%) found that saxagliptin 2.5 mg/day reduced HbA1c by 0.43% from baseline, 5 mg/day reduced it by 0.46% and ... more      

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