A 2-es típusú diabetesben használatos antidiabetikumok tárháza az elmúlt években egy merőben új hatástani csoporttal, az inkretintengelyen ható készítményekkel bővült. Az intenzív kutatás és gyógyszerfejlesztés eredményeképpen e csoporton belül ma már két alcsoportot (inkretinmimetikumok, illetve inkretinhatás-fokozók) is megkülönböztetünk. Az inkretinmimetikumok közé a glükagonszerű-peptid-1 (GLP-1) -receptor-agonista exenatid és a GLP-1-analóg liraglutid tartozik. Az inkretinhatás-fokozók (dipeptidilpeptidáz-4 [DPP-4] -gátlók) közé tartozó sitagliptin, vildagliptin és saxagliptin hazánkban már gyógyszertári forgalomban van, a linagliptin bevezetés előtt áll. Az inkretintengelyen ható készítmények alkalmazására a hazai gyakorlatban a kezelés második lépcsőjében, elsősorban metforminnal kombinációban kerül sor. A jelenlegi közlemény az egyes készítményekkel szerzett fontosabb klinikai tapasztalatokat összegzi, rámutatva az előnyökre és a mérlegelendő körülményekre. Orv. Hetil., 2011, 152, 1931–1940.
Jermendy Gy.: A 2-es típusú diabetes mellitus új terápiás lehetőségei: inkretinmimetikumok és inkretinhatás-fokozó készítmények. LAM, 2008, 18, 761–767.
Jermendy Gy. , 'A 2-es típusú diabetes mellitus új terápiás lehetőségei: inkretinmimetikumok és inkretinhatás-fokozó készítmények ' (2008 ) 18 LAM : 761 -767 .
Jermendy Gy., Winkler G.: Inkretinhatáson alapuló antidiabetikus terápia cukorbetegségben. Medicina Könyvkiadó, Budapest, 2009.
Winkler G. , '', in Inkretinhatáson alapuló antidiabetikus terápia cukorbetegségben , (2009 ) -.
Barnett, A.: Exenatide. Expert Opin. Pharmacother., 2007, 8, 2593–2608.
Barnett A. , 'Exenatide ' (2007 ) 8 Expert Opin. Pharmacother. : 2593 -2608 .
Cvetkovic, R. S., Plosker, G. L.: Exenatide. A review of its use in patients with type 2 diabetes mellitus (as an adjunct to metformin and/or a sulfonylurea). Drugs, 2007, 67, 935–954.
Plosker G. L. , 'Exenatide. A review of its use in patients with type 2 diabetes mellitus (as an adjunct to metformin and/or a sulfonylurea) ' (2007 ) 67 Drugs : 935 -954 .
Schwartz, S. L., Ratner, R. E., Kim, D. D. és mtsai: Effect of exenatide on 24-hour blood glucose profile compared with placebo in patients with type 2 diabetes: a randomized, double-blind, two-arm, parallel-group, placebo-controlled, 2-week study. Clin. Ther., 2008, 30, 858–867.
Kim D. D. , 'Effect of exenatide on 24-hour blood glucose profile compared with placebo in patients with type 2 diabetes: a randomized, double-blind, two-arm, parallel-group, placebo-controlled, 2-week study ' (2008 ) 30 Clin. Ther. : 858 -867 .
DeFronzo, R. A., Ratner, R. E., Han, J. és mtsai: Effects of exenatide (exendin-4) on glycemic control and weight over 30 weeks in metformin-treated patients with type 2 diabetes. Diabetes Care, 2005, 28, 1092–1100.
Han J. , 'Effects of exenatide (exendin-4) on glycemic control and weight over 30 weeks in metformin-treated patients with type 2 diabetes ' (2005 ) 28 Diabetes Care : 1092 -1100 .
Buse, J. B., Henry, R. R., Han, J. és mtsai: Effects of exenatide (exendin-4) on glycemic control over 30 weeks in sulfonylurea-treated patients with type 2 diabetes. Diabetes Care, 2004, 27, 2628–2635.
Han J. , 'Effects of exenatide (exendin-4) on glycemic control over 30 weeks in sulfonylurea-treated patients with type 2 diabetes ' (2004 ) 27 Diabetes Care : 2628 -2635 .
Kendall, D. M., Riddle, M. C., Rosenstock, J. és mtsai: Effects of exenatide (exendin-4) on glycemic control over 30 weeks in patients with type 2 diabetes treated with metformin and a sulfonylurea. Diabetes Care, 2005, 28, 1083–1091.
Rosenstock J. , 'Effects of exenatide (exendin-4) on glycemic control over 30 weeks in patients with type 2 diabetes treated with metformin and a sulfonylurea ' (2005 ) 28 Diabetes Care : 1083 -1091 .
Riddle, M. C., Henry, R. R., Poon, T. H. és mtsai: Exenatide elicits sustained glycaemic control and progressive reduction of body weight in patients with type 2 diabetes inadaequately controlled by sulphonylureas with or without metformin. Diab. Metab. Res. Rev., 2006, 22, 483–491.
Poon T. H. , 'Exenatide elicits sustained glycaemic control and progressive reduction of body weight in patients with type 2 diabetes inadaequately controlled by sulphonylureas with or without metformin ' (2006 ) 22 Diab. Metab. Res. Rev. : 483 -491 .
Buse, J. B., Klonoff, D. C., Nielsen, L. L. és mtsai: Metabolic efects of two years of exenatide treatment on diabetes, obesity, and hepatic biomarkers in patients with type 2 diabetes: an interim analysis of data from the ope-label, uncontrolled extension of three double-blind, placebo-controlled trials. Clin. Ther., 2007, 29, 139–153.
Nielsen L. L. , 'Metabolic efects of two years of exenatide treatment on diabetes, obesity, and hepatic biomarkers in patients with type 2 diabetes: an interim analysis of data from the ope-label, uncontrolled extension of three double-blind, placebo-controlled trials ' (2007 ) 29 Clin. Ther. : 139 -153 .
Klonoff, D. C., Buse, J. B., Nielsen, L. L. és mtsai: Exenatide effects on diabetes, obesity, cardiovascular risk factors and hepatic biomarkers in patients with type 2 diabetes treated for at least 3 years. Curr. Med. Res. Opin., 2008, 24, 275–286.
Nielsen L. L. , 'Exenatide effects on diabetes, obesity, cardiovascular risk factors and hepatic biomarkers in patients with type 2 diabetes treated for at least 3 years ' (2008 ) 24 Curr. Med. Res. Opin. : 275 -286 .
DeFronzo, R. A.: Banting Lecture. From the triumvirate to the ominous octet: a new paradigm for the treatment of type 2 diabetes mellitus. Diabetes, 2009, 58, 773–795.
DeFronzo R. A. , 'Banting Lecture. From the triumvirate to the ominous octet: a new paradigm for the treatment of type 2 diabetes mellitus ' (2009 ) 58 Diabetes : 773 -795 .
Agersø, H., Vicini, P.: Pharmacodynamics of NN2211, a novel long acting GLP-1 derivative. Eur. J. Pharm. Sci., 2003, 19, 141–150.
Vicini P. , 'Pharmacodynamics of NN2211, a novel long acting GLP-1 derivative ' (2003 ) 19 Eur. J. Pharm. Sci. : 141 -150 .
Nauck, M. A., Frid, A., Hermansen, K. és mtsai: Efficacy and safety comparison of liraglutide, glimepiride, and placebo, all in combination with metformin in type 2 diabetes mellitus (LEAD-2 Met). Diabetes Care, 2009, 32, 84–90.
Hermansen K. , 'Efficacy and safety comparison of liraglutide, glimepiride, and placebo, all in combination with metformin in type 2 diabetes mellitus (LEAD-2 Met) ' (2009 ) 32 Diabetes Care : 84 -90 .
Davies, M. J., Kela, R., Khunti, K.: Liraglutide – overview of the preclinical and clinical data and its role in the treatment of type 2 diabetes. Diabetes Obes. Metab., 2011, 13, 207–220.
Khunti K. , 'Liraglutide – overview of the preclinical and clinical data and its role in the treatment of type 2 diabetes ' (2011 ) 13 Diabetes Obes. Metab. : 207 -220 .
Ahrén, B.: Dipeptidyl peptidase-4 inhibitors. Clinical data and clinical implications. Diabetes Care, 2007, 30, 1344–1350.
Ahrén B. , 'Dipeptidyl peptidase-4 inhibitors. Clinical data and clinical implications ' (2007 ) 30 Diabetes Care : 1344 -1350 .
Deacon, C. F.: Dipeptidyl peptidase-4 inhibitors in the treatment of type 2 diabetes: a comparative review. Diabetes Obes. Metab., 2011, 13, 7–18.
Deacon C. F. , 'Dipeptidyl peptidase-4 inhibitors in the treatment of type 2 diabetes: a comparative review ' (2011 ) 13 Diabetes Obes. Metab. : 7 -18 .
Jermendy Gy.: Dipeptidilpeptidáz-4-gátlók (gliptinek): az orális antidiabetikumok új hatástani csoportja. Orv. Hetil., 2011, 152, 1471–1476.
Jermendy Gy. , 'Dipeptidilpeptidáz-4-gátlók (gliptinek): az orális antidiabetikumok új hatástani csoportja ' (2011 ) 152 Orv. Hetil. : 1471 -1476 .
Baetta, R., Corsini, A.: Pharmacology of dipeptidyl peptidase-4 inhibitors: similarities and differences. Drugs, 2011, 71, 1441–1467.
Corsini A. , 'Pharmacology of dipeptidyl peptidase-4 inhibitors: similarities and differences ' (2011 ) 71 Drugs : 1441 -1467 .
Nauck, M. A., Meininger, G., Sheng, D. és mtsai: Efficacy and safety of the dipeptidyl peptidase-4 inhibitor, sitagliptin, compared with the sulfonylurea, glipizide, in patients with type 2 diabetes inadequately controlled on metformin alone: a randomized, double-blind, non-inferiority trial. Diabetes Obes. Metab., 2007, 9, 194–205.
Sheng D. , 'Efficacy and safety of the dipeptidyl peptidase-4 inhibitor, sitagliptin, compared with the sulfonylurea, glipizide, in patients with type 2 diabetes inadequately controlled on metformin alone: a randomized, double-blind, non-inferiority trial ' (2007 ) 9 Diabetes Obes. Metab. : 194 -205 .
Seck, T., Nauck, M., Sheng, D. és mtsai: Safety and efficacy of treatment with sitagliptin or glipizide in patients with type 2 diabetes inadequately controlled on metformin: a 2-year study. Int. J. Clin. Pract., 2010, 64, 562–576.
Sheng D. , 'Safety and efficacy of treatment with sitagliptin or glipizide in patients with type 2 diabetes inadequately controlled on metformin: a 2-year study ' (2010 ) 64 Int. J. Clin. Pract. : 562 -576 .
Barzilai, N., Guo, H., Mahoney, E. M. és mtsai: Efficacy and tolerability of sitagliptin monotherapy in elderly patients with type 2 diabetes: a randomized, double-blind, placebo-controlled trial. Curr. Med. Res. Opin., 2011, 27, 1049–1058.
Mahoney E. M. , 'Efficacy and tolerability of sitagliptin monotherapy in elderly patients with type 2 diabetes: a randomized, double-blind, placebo-controlled trial ' (2011 ) 27 Curr. Med. Res. Opin. : 1049 -1058 .
Williams-Herman, D., Engel, S. S., Round, E. és mtsai: Safety and tolerability of sitagliptin in clinical studies: a pooled analysis of data from 10,246 patients with type 2 diabetes. BMC Endocr. Disord., 2010, 10 (7, Apr 22), 000.
Round E. , 'Safety and tolerability of sitagliptin in clinical studies: a pooled analysis of data from 10,246 patients with type 2 diabetes ' (2010 ) 10 BMC Endocr. Disord. : -.
Jermendy Gy.: Új elméleti és klinikai adatok a cukorbetegek vildagliptin-terápiájával kapcsolatban: irodalmi áttekintés. Metabolizmus, 2011, 9, 218–222.
Jermendy Gy. , 'Új elméleti és klinikai adatok a cukorbetegek vildagliptin-terápiájával kapcsolatban: irodalmi áttekintés ' (2011 ) 9 Metabolizmus : 218 -222 .
Ferrannini, E., Fonseca, V., Zinman, B. és mtsai: Fifty-two-week efficacy and safety of vildagliptin vs. glimepiride in patients with type 2 diabetes mellitus inadequately controlled on metformin monotherapy. Diabetes Obes. Metab., 2009, 11, 157–166.
Zinman B. , 'Fifty-two-week efficacy and safety of vildagliptin vs. glimepiride in patients with type 2 diabetes mellitus inadequately controlled on metformin monotherapy ' (2009 ) 11 Diabetes Obes. Metab. : 157 -166 .
Matthews, D. R., Dejager, S., Ahren, B. és mtsai: Vildagliptin add-on to metformin produces similar efficacy and reduced hypoglycaemic risk compared with glimepiride, with no weight gain: results from a 2-year study. Diabetes Obes. Metab., 2010, 12, 780–789.
Ahren B. , 'Vildagliptin add-on to metformin produces similar efficacy and reduced hypoglycaemic risk compared with glimepiride, with no weight gain: results from a 2-year study ' (2010 ) 12 Diabetes Obes. Metab. : 780 -789 .
Filozof, C., Gautier, J. F.: A comparison of efficacy and safety of vildagliptin and gliclazide in combination with metformin in patients with type 2 diabetes inadequately controlled with metformin alone: a 52-week, randomized study. Diabet. Med., 2010, 27, 318–326.
Gautier J. F. , 'A comparison of efficacy and safety of vildagliptin and gliclazide in combination with metformin in patients with type 2 diabetes inadequately controlled with metformin alone: a 52-week, randomized study ' (2010 ) 27 Diabet. Med. : 318 -326 .
Bolli, G., Dotta, F., Colin, L. és mtsai: Comparison of vildagliptin and pioglitazone in patients with type 2 diabetes inadequately controlled with metformin. Diabetes Obes. Metab., 2009, 11, 589–595.
Colin L. , 'Comparison of vildagliptin and pioglitazone in patients with type 2 diabetes inadequately controlled with metformin ' (2009 ) 11 Diabetes Obes. Metab. : 589 -595 .
Kania, D. S., Gonzalvo, J. D., Weber, Z. A.: Saxagliptin: a clinical review in the treatment of type 2 diabetes mellitus. Clin. Ther., 2011, 33, 1005–1022.
Weber Z. A. , 'Saxagliptin: a clinical review in the treatment of type 2 diabetes mellitus ' (2011 ) 33 Clin. Ther. : 1005 -1022 .
Nathan, D. M., Buse, J. B., Davidson, M. B. és mtsai: Medical management of hyperglycemia in type 2 diabetes: a consensus algorithm for the initiation and adjustment of therapy. A consensus statement from the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care, 2009, 32, 193–203.
Davidson M. B. , 'Medical management of hyperglycemia in type 2 diabetes: a consensus algorithm for the initiation and adjustment of therapy. A consensus statement from the American Diabetes Association and the European Association for the Study of Diabetes ' (2009 ) 32 Diabetes Care : 193 -203 .
Jermendy Gy.: Miért metformin? Mit metformin után? Háziorvos Továbbképző Szemle, 2010, 15, 233–236.
Jermendy Gy. , 'Miért metformin? Mit metformin után? ' (2010 ) 15 Háziorvos Továbbképző Szemle : 233 -236 .
A diabetes mellitus kórismézése, a cukorbetegek kezelése és gondozása felnőttkorban. A Magyar Diabetes Társaság szakmai irányelve, 2011 (Szerk.: Jermendy Gy., írta: Gaál Zs., Gerő L., Hidvégi T., Jermendy Gy., Kempler P., Winkler G.). Diabetologia Hungarica, 2011, 19 (Suppl. 1.), 5–72.
Winkler G. , 'A diabetes mellitus kórismézése, a cukorbetegek kezelése és gondozása felnőttkorban. A Magyar Diabetes Társaság szakmai irányelve ' (2011 ) 19 Diabetologia Hungarica : 5 -72 .
Madsbad, S., Kielgast, U., Asmar, M. és mtsai: An overview of once-weekly GLP-1 receptor agonists – available efficacy and safety data and perspectives for the future. Diabetes Obes. Metab., 2011, 13, 394–407.
Asmar M. , 'An overview of once-weekly GLP-1 receptor agonists – available efficacy and safety data and perspectives for the future ' (2011 ) 13 Diabetes Obes. Metab. : 394 -407 .
Barnett, A. H.: Linagliptin: a novel dipeptidyl peptidase 4 inhibitor with a unique place in therapy. Adv. Ther., 2011, 28, 447–459.
Barnett A. H. , 'Linagliptin: a novel dipeptidyl peptidase 4 inhibitor with a unique place in therapy ' (2011 ) 28 Adv. Ther. : 447 -459 .
Drucker, D. J., Sherman, S. I., Bergenstal, R. M. és mtsa: The safety of incretin-based therapies – review of the scientific evidence. J. Clin. Endocrinol. Metab., 2011, 96, 2027–2031.
Bergenstal R. M. , 'The safety of incretin-based therapies – review of the scientific evidence ' (2011 ) 96 J. Clin. Endocrinol. Metab. : 2027 -2031 .
Addison, D., Aguilar, D.: Diabetes and cardiovascular disease: the potential benefit of incretin-based therapies. Curr. Atheroscler. Rep., 2011, 13, 115–122.
Aguilar D. , 'Diabetes and cardiovascular disease: the potential benefit of incretin-based therapies ' (2011 ) 13 Curr. Atheroscler. Rep. : 115 -122 .