Starlix Found to Reduce Liver Fat
Japanese researchers are saying that the oral medication nateglinide (Starlix) decreases liver fat content in patients with type 2.
Thirty-nine patients were randomly assigned to treatment for 12 weeks with either Starlix (270 mg per day) or voglibose—an alpha-glucosidase inhibitor—(0.6 mg per day). Both drugs decreased BG levels; however, people taking Starlix showed better liver function and had lower triglycerides than the voglibose group.
“[Starlix] may decrease liver fat content and may be beneficial for the treatment of nonalcoholic fatty liver disease in patients with impaired glucose tolerance and type 2 diabetes,” say the researchers.[572-P]
Januvia Doing Well in Clinical Trials
Merck’s investigational DPP-4 inhibitor, Januvia, demonstrated positive results on blood glucose levels, according to newly released phase III data.
When administered to people with type 2 at 100-mg dosages once daily, Januvia was found to significantly lower A1C and fasting plasma glucose over the course of 12 weeks. At 12 weeks A1C dropped an average 1.05%, while fasting plasma glucose dropped 31.9 mg/dl with two-hour aftermeal glucose dropping an average of 80.9 mg/dl.
In a separate study, 100-mg dosages of Januvia had, at 24 weeks, lowered A1C an average of 0.79 %, fasting plasma glucose an average of 17.1 mg/dl and two-hour after meal glucose an average of 46.7 mg/dl.[537-P] 1995-PO
Januvia May Benefit Type 2s Not Controlled With Actos
Type 2s who are not adequately controlled with Actos may benefit from the experimental drug Januvia.
A 24-week study assessed adding once-daily Januvia, a DPP-4 inhibitor, to type 2s treated with Actos. The combined regimen showed a 0.70 percent reduction in A1C and a 17.7 mg/dl reduction in fasting plasma glucose. Januvia was also was well tolerated.
Researchers note, however, that a “slightly higher incidence of abdominal pain was observed” in people taking Januvia.[556-P]
Myopathy May Be More Likely in People Who Use a Statin
Progressive muscle weakness—also known as myopathy—may be more likely in people taking statins. In fact, researchers suggest it may be higher in “real-world use than the less than 1 percent reported in clinical trials.”
Researchers admit that little is known about how anti-diabetic therapies might interact with statins to affect myopathy risk. Using records from Kaiser Permanente Northwest, researchers identified 10,247 patients with type 2 who initiated statin therapy between 1997 and 2004. These patients were then matched with 10,247 diabetic patients who were not exposed to statins.
“Among patients using statins, the incidence rate of myopathy was … 37 percent higher than among subjects who were not exposed to statins,” say the researchers. “Older age, higher body mass index, female sex and use of fibrates, corticosteroids or sulfonylureas were associated with increased risk of myopathy and myalgia.”
The researchers note, however, that interactions between statins and antidiabetic drugs “were not significant in any model.”[536-P]
DPP-4 Inhibitor Works as Well as TZD
Vildagliptin (Galvus), an oral medication in development by Novartis, was found to be as effective and well tolerated in type 2s as Avandia. Researchers tested the DPP-4 inhibitor on a type 2 patient population and found that Galvus demonstrated similar blood-glucose reductions as Avandia but without weight gain and an improved lipid profile.[557-P]