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Tradjenta and metformin better than metformin alone for reducing prediabetes progression

A December 2019 study found that prediabetic adults who took Tradjenta (linagliptin) and metformin together were less likely to develop type 2 diabetes than those who took metformin alone.

“It has been demonstrated that treatment of prediabetes reduces the risk of micro- and macrovascular complications, as well as global mortality, highlighting the relevance of early treatments for glucose abnormalities,” said Rodolfo Guardado-Mendoza, MD, PhD. “Evaluation of new alternatives for patients with prediabetes is needed to generate scientific evidence about the safety and efficacy profile of these therapies to treat hyperglycemia at early stages.”

Researchers studied 144 prediabetic adults over 24 months. 74 of the participants were given 2.5 mg of linagliptin and 850 mg of metformin twice per day. 70 of the participants were given only 850 mg of metformin twice per day.

Four of the participants who took both medications had type 2 diabetes after 24 months. Ten of the participants who took only metformin had type 2 diabetes after 24 months. 52.7% of those who took both medications achieved normal glycemic levels at 24 months. Only 33.3% of those who took metformin alone achieved normal glycemic levels at 24 months.

Tradjenta is a drug used for the treatment of diabetes mellitus type 2. Metformin and sulfonylureas are generally preferred over Tradjenta for this purpose. Tradjenta is a dipeptidyl peptidase-4 (DPP-4) inhibitor. It functions by increasing insulin production and decreasing glucagon production. The FDA approved its use in the United States in 2011. Severe joint pain is a known side effect of Tradjenta. Common side effects of Tradjenta include back pain, joint pain, head pain and throat irritation. Infrequent side effects of Tradjenta include diarrhea, cough and high lipase enzyme blood levels.

The FDA added a warning to Tradjenta’s label in 2016 warning of cases of bullous pemphigoid requiring hospitalization associated with DPP-4 inhibitor use. Bullous pemphigoid is a rare skin condition which is characterized by large blisters filled with fluid. This condition must be treated quickly because it can lead to infection and sepsis. The following are symptoms of bullous pemphigoid:

• Itchy skin weeks to months before blister formation

• Large blisters which don’t burst easily when touched

• Skin surrounding the blisters which is either normal, darker than usual or reddish

• Eczema or a rash which resembles hives

• Small sores or blisters inside the mouth or inside other mucous membranes

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John Elliot

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