Jentadueto® tablets receive approval for the treatment of adults with Type 2 Diabetes in Europe

“We’re delighted that linagliptin/metformin hydrochloride (HCl) will soon be available across Europe to help people with Type 2 Diabetes,” said Prof. Klaus Dugi, Corporate Senior Vice President Medicine, Boehringer Ingelheim. “Many patients need more than one treatment to adequately manage their diabetes. Linagliptin/metformin hydrochloride (HCl) offers a simplified, single tablet dosing option, to improve glycaemic control and with a favourable side effect profile.”

The European Commission has approved linagliptin/metformin hydrochloride (HCl) for use alongside diet and exercise to improve glycaemic control in adults with Type 2 Diabetes who are inadequately controlled on their maximal tolerated dose of metformin alone, metformin and a sulphonylurea, or those already being treated with the combination of linagliptin and metformin. ¹ It may also be used with a sulphonylurea.

In clinical trials, statistically significant, placebo-corrected mean reductions in haemoglobin A1c (HbA1c or A1C) levels of -1.7 percent were observed in patients with inadequate glycaemic control when the maximum dose of 2.5 mg linagliptin/1,000 mg metformin HCI was administered twice daily. 1.2 HbA1c is measured in people with diabetes to provide an index of blood glucose control for the previous two to three months. In clinical studies, linagliptin/metformin HCl did not cause any significant change in body weight, and can be used alone or in combination with a sulphonylurea, a commonly prescribed medication for Type 2 Diabetes. ¹

Linagliptin/Metformin HCl Clinical Trials

In a 24-week, randomised, double-blind, placebo controlled study evaluating 791 patients with Type 2 Diabetes and inadequate glycaemic control with diet and exercise, 2.5 mg linagliptin/1,000 mg metformin HCl twice daily demonstrated the following: ¹

• Statistically significant, placebo-corrected mean HbA1c reductions of -1.7 percent
• Statistically significant reductions in fasting plasma glucose (FPG) of -60 mg/dL. FPG is used to determine glucose levels in a fasting state (usually upon waking in the morning)

The approval of linagliptin/metformin HCl tablets was based on clinical trials that evaluated linagliptin and metformin as separate tablets. Bioequivalence of linagliptin/metformin HCl was demonstrated in a previous study, with co-administered linagliptin and metformin tablets in healthy subjects with Type 2 Diabetes. ^1,2

In clinical studies, adverse reactions were uncommon. Gastrointestinal disorders occurred most frequently during initiation therapy with linagliptin/metformin HCl or metformin HCl and tended to resolve spontaneously. A comparable rate of diarrhoea was reported with linagliptin/metformin HCl treatment versus metformin plus placebo. ² Due to the impact of background therapy, hypoglycaemia was more commonly reported in patients treated with the combination of linagliptin/metformin HCl and sulphonylurea compared with those treated with the combination of placebo, metformin and sulphonylurea. ¹

Linagliptin (5 mg, once-daily) is marketed as Trajenta® across Europe and Canada, as Tradjenta® in the US, and Trazenta® in Japan, as well as in additional markets.

About Linagliptin/Metformin HCl

Linagliptin/metformin HCl is not intended to be used in patients with Type 1 Diabetes or for the treatment of diabetic ketoacidosis (increased ketones in the blood or urine). ^1,3

The use of linagliptin/metformin HCl in combination with insulin has not been adequately studied. ^1,3

Linagliptin/metformin HCl will be made available in the following twice-daily doses in Europe: 2.5 mg linagliptin/850 mg metformin tablets and 2.5 mg linagliptin/1,000 mg metformin tablets. ¹

About Linagliptin

Linagliptin is an inhibitor of the enzyme DPP-4 (dipeptidyl peptidase-4) which is involved in the inactivation of the incretin hormones GLP-1 and GIP (glucagon-like peptide-1, glucose-dependent insulinotropic polypeptide). Linagliptin glucose-dependently increases insulin secretion and lowers glucagon secretion thus resulting in an overall improvement in the glucose homoeostasis. ¹

Linagliptin (5 mg, once-daily) is marketed as Trajenta® across Europe and Canada, as Tradjenta® in the US, and Trazenta® in Japan, as well as in additional markets. ^4,5

Linagliptin is a prescription medicine that is used along with diet and exercise to lower blood glucose in adults with Type 2 Diabetes.4,5 Linagliptin is not for people with Type 1 Diabetes or for people with diabetic ketoacidosis (increased ketones in the blood or urine). 4,5 It is not known if linagliptin is safe and effective when used with insulin. ⁵

About Diabetes

An estimated 366 million people worldwide have Type 1 and Type 2 Diabetes. 6 Type 2 Diabetes is the most common type, accounting for an estimated 85 to 95% of all diabetes cases. ⁷ Diabetes is a chronic disease that occurs when the body either does not properly produce, or use, the hormone insulin. ⁸

References

1. Jentadueto™ (linagliptin/metformin HCI) tablets. EMA Summary of Product Characteristics. 2012
2. Haak T, Meinicke T, Jones R, Weber S, Eynatten M von, Woerle HJ Initial combination of linagliptin and metformin improves glycaemic control in type 2 diabetes: a randomised, double-blind, placebo-controlled study. Diabetes Obesity and Metabolism, Accepted manuscript online: 22 FEB 2012, doi: 10.1111/j.1463-1326.2012.01590.x Diabetes Obes Metab 14 (6) , 565-574 (2012)
3. Jentadueto™ (linagliptin/metformin HCI) tablets. Highlights of Prescribing Information. Initial US Approval: 2012
4. Trajenta™ (linagliptin) tablets. EMA Summary of Product Characteristics. Approval 25 September 2011. www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Product_Information/human/002110/WC500115745.pdf
5. Tradjenta™ (linagliptin) tablets. Highlights of Prescribing Information. Initial U.S. Approval: 2011.
6. International Diabetes Federation. IDF Diabetes Atlas, 5th Edition: The Global Burden http://www.idf.org/diabetesatlas/5e/the-global-burden. Accessed on: June 21, 2012.
7. International Diabetes Federation. IDF Diabetes Atlas, 5th Edition: Diabetes http://www.idf.org/diabetesatlas/5e/diabetes. Accessed on: June 21, 2012.
8. International Diabetes Federation. IDF Diabetes Atlas, 5th Edition: What is Diabetes? http://www.idf.org/diabetesatlas/5e/what-is-diabetes. Accessed on: June 21, 2012.