DPPs to the fore

The first of the dipeptidyl peptidase-4 inhibitors reached shore last week as FDA approved Merck & Co. Inc.'s Januvia sitagliptin for Type II diabetes. Januvia's label suggests that it will be used in combination with established products like metformin and PPAR gamma agonists, while its oral administration and safety profile mean it could start to supplant sulfonylureas. MRK's head start may not be long-lived, however, as a decision is expected shortly from FDA on Galvus vildagliptin, a DPP-4 inhibitor from Novartis AG.

Glucagon-like peptide-1 (GLP-1) is an incretin hormone that stimulates pancreatic beta cells to produce insulin and alpha cells to stop producing glucagon, both of which are believed to help reduce the amount of glucose in circulation. Because DPP-4 enzymes have been shown to break down GLP-1, DPP-4 inhibitors have long been expected to play an important role in the treatment of Type II diabetes...