Januvia is the first Dipeptidyl Peptidase-4 Inhibitor approved as add-on to metformin or a glitazone for treatment of type 2-diabetes. The recommended dose is 100 mg (1 tablet) a day.
After 24 - 52 weeks of treatment Januvia resulted in an average HbA1c-reduction of 0,7 percentage points. Januvia is superior to placebo and non-inferior to glipizide with regards to HbA1c-reductions. Adverse effects, such as nausea, abdominal pain, flatulens, and somnolens occured in few patients. Januvia did not lead to weight gain or hypoglycaemia compared to glipizide.
The price for treatment in one month is 520 Dkr which is 7 – 50 times more expensive than treatment with a sulfonylurea but comparable to treatment with glitazones. Januvia is generally reimbursed.
Januvia as add-on to metformin or a glitazone could be a solution for patients who, despite careful dose titration, suffer from recurrent episodes of hypoglycaemia when treated with a sulfonylurea.
Januvia was marketed 23 April 2007.
Institute for Rational Pharmacotherapy, 2 May 2007