The dipeptidyl peptidase IV inhibitor LAF237 prevents deterioration of glycemic control in type 2 diabetics treated with metformin, according to a report in the December issue of Diabetes Care.

LAF237 has been shown to improve glucose tolerance in animal models of type 2 diabetes and in diabetic patients, the authors explain, but this is the first long-term study of its efficacy and tolerability.

Dr. Bo Ahren from Lund University in Sweden investigated the effectiveness of LAF237 in 107 patients with type 2 diabetes, 71 of whom participated in a 40-week extension of the 12-week core study. All patients were receiving metformin.

Glycosylated hemoglobin levels improved among the LAF237-treated patients during the 12-week study, but remained stable among placebo-treated patients, the authors report.

During the ensuing 40 weeks, glycosylated hemoglobin levels remained stable in LAF237-treated patients but increased gradually in placebo-treated patients, the report indicates.

Fasting plasma glucose levels were lower in the core study and in the extension period among LAF237-treated patients, the researchers note, but plasma insulin levels did not differ between the treatment groups.

Lipid profiles and body weight did not differ during the core study, the investigators report, but the LAF237-treated group had a modest decrease in total cholesterol during the extension study.
Adverse events were similar in LAF237- and placebo-treated patients, the results indicate.

"The mechanism by which LAF237 improved glycemic control in these metformin-treated patients was not directly addressed," the researchers write. "However, it is likely attributable to inhibition of dipeptidyl peptidase IV and resultant increases of circulating levels of the intact, biologically active incretins."

"Although larger and longer-term studies in a variety of patient populations will be required to fully establish the efficacy and safety of LAF237," the authors conclude, "inhibition of dipeptidyl peptidase IV is a promising new approach for the treatment of type 2 diabetes and may be useful in a broad spectrum of patients."

Source: Diabetes In Control.com: Diabetes Care 2004;27:2874-2880.