Dipeptidyl peptidase IV (DPP-IV) inhibitors are a new approach to the treatment of type 2 diabetes. The efficacy of DPP-IV inhibitors is mediated primarily via stabilization of the incretin hormones glucagon-like peptide 1 (GLP-1) and glucose-dependent insulinotropic polypeptide. Incretin action is very brief and is terminated by their breakdown by the enzyme dipeptidyl peptidase-IV (DPP-IV). Merck & Co has introduced the first DPP-IV inhibitor for treatment of type 2 diabetes. Sitagliptin already posted in its second year after the first launch 2007 global sales of US$ 754 mln demonstrating a quite enthusiastic acceptance by the market. Although the FDA raised the bar for approval of new DPP-IV inhibitors by requesting more clinical data from Novartis before approving vildagliptin, this has not deterred competitors from pursuing development of novel DPP-IV inhibitors. At least 14 different molecules are currently in clinical development and further are to follow.

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