Boehringer Ingelheim and Eli Lilly have begun sales of Tradjenta, a drug for type 2 diabetes, in U.S. pharmacies. The drug (generic name linagliptin) comes in tablet form and is intended to compete with Amylin Pharmaceuticals’ Byetta, which is injected, and Merck’s Januvia, which also competes with Byetta. Both are well-established in the U.S. market.
Like Januvia, Tradjenta is a DPP-4 inhibitor that blocks an enzyme that interferes with a hormone that stimulates after-meal insulin production. This leads to more insulin in the bloodstream, which lowers blood glucose levels.
The new drug was tested in eight double-blind, placebo-controlled studies that involved 3,800 type 2 patients. It was tested as a standalone therapy and in combination with such standard diabetes drugs as metformin and glimepiride. It is likely that in most cases, Tradjenta will be prescribed as an adjunct to, rather than a replacement for, other drugs.
Despite competing head-to-head against well-established drugs, Tradjenta does bring one competitive advantage to the table: It is taken only once daily and does not pass through the kidneys on the way to excretion. Instead, the drug is expressed through bile and the gut, which makes it safe for patients with kidney problems.