Efficacy and Safety of Once Weekly Oral Trelagliptin Switched From Once Daily Sitagliptin in the Glycaemic Control of Type 2 Diabetes Mellitus

Muhammad Muzaffar  Nawaz; Muhammad Zafar  Iqbal; Muhammad  Sajid

doi:10.54112/bcsrj.v6i6.1822

Authors

Muhammad Muzaffar Nawaz Department of Endocrinology, Nishtar Medical University And Hospital Multan, Pakistan
Muhammad Zafar Iqbal Department of Endocrinology, Nishtar Medical University And Hospital Multan, Pakistan
Muhammad Sajid Department of Endocrinology, Nishtar Medical University And Hospital Multan, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v6i6.1822

Keywords:

Compliance, Dipeptidyl Peptidase IV Inhibitors, Glycated Hemoglobin A, Hypoglycemia, Sitagliptin Phosphate, Trelagliptin, Type 2 Diabetes Mellitus

Abstract

Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder requiring effective long-term glycaemic control. Dipeptidyl peptidase-4 (DPP-4) inhibitors such as sitagliptin are commonly used for glucose regulation. Trelagliptin, a once-weekly oral DPP-4 inhibitor, offers the potential for improved patient compliance. Objective: To evaluate the efficacy (glycaemic control) and safety of once-weekly oral trelagliptin in comparison to once-daily sitagliptin in patients with T2DM. Methods: This quasi-experimental (pre-post intervention) study was conducted at the Diabetes and Endocrine Unit, Nishtar Hospital, Multan, from November 2024 to April 2025. A total of 35 patients aged >12 years with well-controlled HbA1c (6.5–8.5%) on sitagliptin therapy were enrolled. Patients with a history of hypoglycaemia, diabetic ketoacidosis, or diabetic coma in the preceding 6 months were excluded. After switching from sitagliptin to trelagliptin, HbA1c levels were recorded to assess glycaemic control. Data were analysed using SPSS version 26. Quantitative variables were summarized using means and standard deviations, and categorical variables using frequencies and percentages. A paired-samples t-test was used to compare pre- and post-intervention HbA1c values. Results: The mean age of the participants was 49.8 ± 10.5 years, with females comprising 60% of the study population. Mean HbA1c prior to switching (sitagliptin) was 7.37 ± 0.61%, and after switching to trelagliptin was 7.41 ± 0.68% (p > 0.05), indicating comparable glycaemic control. Improved compliance was noted with once-weekly trelagliptin. Minor side effects were reported in 17.1% of patients, with no major or life-threatening adverse events observed. Conclusion: Once-weekly oral trelagliptin demonstrated comparable glycaemic control to daily sitagliptin, with good patient compliance and an acceptable safety profile, making it a viable alternative in the management of T2DM.

Downloads

Download data is not yet available.

References

Masharani U, German MS. Pancreatic hormones and diabetes mellitus. Greenspan’s basic & clinical endocrinology. 2011;8.

Galicia-Garcia U, Benito-Vicente A, Jebari S, Larrea-Sebal A, Siddiqi H, Uribe KB, et al. Pathophysiology of type 2 diabetes mellitus. International journal of molecular sciences. 2020;21(17):6275. https://doi.org/10.3390/ijms21176275

Farmaki P, Damaskos C, Garmpis N, Garmpi A, Savvanis S, Diamantis E. Complications of the type 2 diabetes mellitus. Current cardiology reviews. 2020;16(4):249-51. https://doi.org/10.2174/1573403X1604201229115531

Torm MEW, Dorweiler TF, Fickweiler W, Levine SR, Fort PE, Sun JK, et al. Frontiers in diabetic retinal disease. Journal of Diabetes and its Complications. 2023;37(2):108386. https://doi.org/10.1016/j.jdiacomp.2022.108386

Klein S, Sheard NF, Pi-Sunyer X, Daly A, Wylie-Rosett J, Kulkarni K, et al. Weight management through lifestyle modification for the prevention and management of type 2 diabetes: rationale and strategies: a statement of the American Diabetes Association, the North American Association for the Study of Obesity, and the American Society for Clinical Nutrition. Diabetes care. 2004;27(8):2067-73. https://doi.org/10.2337/diacare.27.8.2067

Nurchis MC, Sessa G, Pascucci D, Sassano M, Lombi L, Damiani G. Interprofessional collaboration and diabetes Management in Primary Care: a systematic review and meta-analysis of patient-reported outcomes. Journal of personalized medicine. 2022;12(4):643. https://doi.org/10.3390/jpm12040643

Freedman R, Herbert L, O'Donnell A, Ross N, Wilson IH, Allman KG. Oxford Handbook of Endocrinology & Diabetes 4e: Oxford University Press; 2022.

Inagaki N, Sano H, Seki Y, Kuroda S, Kaku K. Efficacy and safety of once‐weekly oral trelagliptin switched from once‐daily dipeptidyl peptidase‐4 inhibitor in patients with type 2 diabetes mellitus: an open‐label, phase 3 exploratory study. Journal of Diabetes Investigation. 2018;9(2):354-9. https://doi.org/10.1111/jdi.12730

Kaku K, Kuroda S, Ishida K, Umeda Y. Efficacy and safety of trelagliptin in combination with insulin therapy in Japanese patients with type 2 diabetes: Results from a randomized, Phase IV study. Diabetes, Obesity and Metabolism. 2018;20(10):2490-3. https://doi.org/10.1111/dom.13397

Dutta D, Mohindra R, Surana V, Sharma M. Safety and efficacy of once weekly dipeptidyl-peptidase-4 inhibitor trelagliptin in type-2 diabetes: a meta-analysis. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2022;16(4):102469. https://doi.org/10.1016/j.dsx.2022.102469

Inagaki N, Onouchi H, Sano H, Funao N, Kuroda S, Kaku K. SYR-472, a novel once-weekly dipeptidyl peptidase-4 (DPP-4) inhibitor, in type 2 diabetes mellitus: a phase 2, randomised, double-blind, placebo-controlled trial. The Lancet Diabetes & Endocrinology. 2014;2(2):125-32.

https://doi.org/10.1016/S2213-8587(13)70149-9

Yamada T, Shojima N, Noma H, Yamauchi T, Kadowaki T. Weekly versus daily dipeptidyl peptidase 4 inhibitor therapy for type 2 diabetes: systematic review and meta-analysis. Diabetes Care. 2018;41(4):e52-e5. https://doi.org/10.2337/dc17-2095

Oita M, Miyoshi H, Ono K, Nakamura A, Cho KY, Nomoto H, et al. Satisfaction and efficacy of switching from daily dipeptidyl peptidase-4 inhibitors to weekly trelagliptin in patients with type 2 diabetes—Randomized controlled study—. Endocrine Journal. 2018;65(2):141-50. https://doi.org/10.1507/endocrj.EJ17-0303

Chandra R, Kumar R, Haque S, Katiyar D. Trelagliptin Path: From regulatory setbacks in the west to approval in India. 2025. https://doi.org/10.30574/wjbphs.2025.21.3.0258

Ito H, Ando S, Tsugami E, Araki R, Kusano E, Matsumoto S, et al. Changes in medication adherence and unused drugs after switching from daily dipeptidyl peptidase-4 inhibitors to once-weekly trelagliptin in patients with type 2 diabetes. Diabetes Research and Clinical Practice. 2019;153:41-8. https://doi.org/10.1016/j.diabres.2019.05.025

Meguro S, Matsui S, Itoh H. Treatment preference for weekly versus daily DPP-4 inhibitors in patients with type 2 diabetes mellitus: outcomes from the TRINITY trial. Current Medical Research and Opinion. 2019;35(12):2071-8. https://doi.org/10.1080/03007995.2019.1651130

Mowaka S, Ashoush N, Tadros MM, Ayoub BM. Investigation of Pharmacokinetic Parameters of Trelagliptin in Egyptian Volunteers Using Sensitive LC‐MS/MS: A Comparative Study with a Japanese Population. Journal of Analytical Methods in Chemistry. 2021;2021(1):9664099. https://doi.org/10.1155/2021/9664099

稲垣. Long‐term safety and efficacy of a novel once‐weekly oral trelagliptin as monotherapy or in combination with an existing oral antidiabetic drug in patients with type 2 diabetes mellitus: A 52‐week open‐label, phase 3 study. Journal of Diabetes Investigation. 2016;7(5):718-26. https://doi.org/10.1111/jdi.12499

Nishimura R, Osonoi T, Koike Y, Miyata K, Shimasaki Y. A randomized pilot study of the effect of trelagliptin and alogliptin on glycemic variability in patients with type 2 diabetes. Advances in Therapy. 2019;36:3096-109. https://doi.org/10.1007/s12325-019-01097-z