The Pharmaceutical Journal
Vol 280 No 7494 p328
22 March 2008

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Vildagliptin launched by Novartis for dual therapy in type 2 diabetes

Patients with type 2 diabetes could be suitable for treatment with a new medicine, vildagliptin, available in the UK this week. Novartis has launched the drug both as a single ingredient tablet (Galvus) and as a combination product with metformin (Eucreas).

Galvus has received a licence for dual therapy in combination with:

• Metformin, for patients with insufficient glycaemic control despite the maximum tolerated dose of monotherapy with metformin

• A sulphonylurea, for patients with insufficient glycaemic control despite maximal tolerated dose of a sulphonylurea and for whom metformin is inappropriate due to contraindications or intolerance

• A thiazolidinedione, for patients with insufficient glycaemic control and for whom the use of a thiazolidinedione is appropriate

Vildagliptin belongs to the dipeptidyl peptidase-4 (DPP-4) inhibitor class of antidiabetic drugs. As a potent and selective inhibitor of DPP-4, vildagliptin causes rapid and complete inhibition of DPP-4 activity, resulting in increased fasting and postprandial endogenous levels of the incretin hormones GLP-1 (glucagon-like peptide 1) and GIP (glucose-dependent insulinotropic polypeptide).

According to Novartis, increasing these incretin hormones enhances the sensitivity of beta cells to glucose resulting in improved glucose-dependent insulin secretion. By raising GLP-1 levels the drug also enhances the sensitivity of alpha cells to glucose, resulting in more glucose-appropriate glucagon secretion.