薬理と治療

Abstract

Background A recent meta︱analysis indicated that the baseline body mass index （BMI）was correlated with the efficacy of dipeptidyl peptidase-4（DPP-4）inhibitors for lowering HbA1c levels. We assessed whether the HbA1c︱lowering effect of anagliptin was influenced by the presence of obesity in Japanese patients with type 2 diabetes. Methods This study incorporated data from phase Ⅱ and phase Ⅱ╱Ⅲ trials, and mean changes in HbA1c levels from baseline to 12 weeks after the administration of anagliptin were analyzed by the baseline BMI and HOMA-IR. In addition, we analyzed the HbA1c-lowering effects of anagliptin at 52 weeks by the baseline BMI in phase Ⅲ trial. Additionally, we investigated factors that influenced the efficacy of anagliptin for lowering HbA1c levels. Results After 12 weeks of anagliptin treatment, the mean changes in HbA1c levels did not differ significantly between the groups with baseline BMI＜25 kg╱m2 and BMI≳25 kg╱m2（－0.74％ vs. －0.71％, respectively；P＝0.662）. Moreover, mean changes in HbA1c levels at 12 weeks were not correlated with the baseline HOMA︱IR values（r＝－0.086, P＝0.207）. At 52 weeks, the HbA1c︱lowering efficacy of anagliptin in the 2 groups with baseline BMI＜25 kg╱m2 and BMI≳25 kg╱m2 was not different（－0.70％ vs. －0.54％, respectively；P＝0.238）.Weight gain from 24 weeks to 52 weeks was significantly related to poor glycemic control at long-term monotherapy with anagliptin. Conclusions The HbA1c-lowering efficacy of anagliptin monotherapy was not influenced by the presence of obesity.