The Midlands Therapeutic Review and Advisory Committee has published an updated review of sitagliptin (Januvia®).
This review places sitagliptin as having a lower place in therapy but supported by stronger evidence. In combination with other hypoglycaemic drugs it has been shown to lower HbA1c to a greater extent than placebo and has been shown to be non-inferior to glipizide.
MTRAC recommends that, "sitagliptin is suitable for prescribing in primary care upon the advice of a specialist or a GP with a special interest in diabetes". This update notes that sitagliptin can now be used, within license, in combination with metformin and a sulphonylurea for patients who fail to achieve adequate glycaemic control.
Action: Clinicians should be aware of the licence extension for sitagliptin. This drug is still new to the market and should be used cautiously; any suspected adverse drug reactions should be reported through the YellowCard system.