The Midlands Therapeutic Review and Advisory Committee has published an updated review of sitagliptin (Januvia®).
This review still places sitagliptin as having a lower place in therapy but supported by stronger evidence. It was previously known that in combination with other hypoglycaemic drugs it has been shown to lower HbA1c to a greater extent than placebo. Additional research since the last review in 2008 has demonstrated that monotherapy also reduced HbA1c to a greater extent than placebo. However, there are still no long term data for sitagliptin on mortality or cardiovascular outcomes.
MTRAC recommends that, "sitagliptin is suitable for prescribing in primary care within its licensed indications and according to National Institute for Health and Clinical Excellence (NICE) guidance".
Action: Clinicians should be aware of this review. It is a useful summary of the current evidence and makes sound recommendations for the use of sitagliptin.