Clinical utility and tolerability of linagliptin in diabetic patients

Lauralee Gordon Maxwell,1 M Shawn McFarland1,21Department of Veterans Affairs, TN Valley Healthcare System, Murfreesboro, 2The University of Tennessee Department of Clinical Pharmacy, Memphis, TN, USABackground: The purpose of this paper is to review the efficacy, safety, and tolerability of linagliptin in the management of hyperglycemia in adults with type 2 diabetes mellitus.Methods: A Medline search was performed using the keywords “linagliptin” and “type 2 diabetes” for articles published September 2010 through July 2012. The literature search was limited by the following criteria: articles' publication in the English language, clinical trials, randomized controlled trials, and research conducted in humans.Results: A review of the data for linagliptin in the treatment of type 2 diabetes as monotherapy or in combination with other antidiabetic therapies suggests clinical efficacy in terms of reductions in glycosylated hemoglobin, fasting plasma glucose, and postprandial glucose. Most adverse events with linagliptin are considered to be mild to moderate in nature. Although linagliptin therapy may offer a low risk of hypoglycemia, the risk increases when it is used in combination with insulin secretagogues. Linagliptin can generally be considered weight neutral, but a weight increase was observed when linagliptin was used in combination with a thiazolidinedione.Conclusion: Linagliptin is a once-daily oral medication used for the treatment of type 2 diabetes. The use of linagliptin as monotherapy or in combination with metformin, sulfonylureas, or pioglitazone led to improvement in glycemic control and was well tolerated by most patients.Keywords: type 2 diabetes, linagliptin, dipeptidyl peptidase-4 inhibitor