[Saxagliptin (Onglyza): new inhibitor of the dipeptidylpeptidase-4 for the oral treatment of type 2 diabetes].

Saxagliptin (Onglyza) is a specific and reversible inhibitor of dipeptidylpeptidase-4 (DPP-4), which inhibits the activity of the enzyme for at least 24 hours after one single oral administration. It increases the circulating levels of incretin hormones (GLP-1, GIP), which contributes to amplify the insulin secretory response to meals and to reduce postprandial hyperglycaemia and, subsequently, fasting glycaemia. Saxagliptin, 5 mg once daily, has been shown to be effective in patients with type 2 diabetes treated with diet alone, metformin, sulfonylurea or glitazone, with a favourable tolerance profile. Reduction in glycated haemoglobin (HbA(1c)) averaged 0.6-0.8%, without increasing the risk of hypoglycaemia or promoting weight gain. The only indication of saxagliptin that is currently reimbursed in Belgium is the treatment of patients not controlled with metformin, the oral antidiabetic agent that is recommended as first line therapy in the management of type 2 diabetes.