Another Glinide: Where's the Beef?

Implications: Elixir has turned to a strategy devoid of innovation by selecting a combination glinide (metiglinide) plus glucophage for treatment of type 2 diabetes.  With the new availability of DPP4 inhibitors (sitagliptin/alogliptin) and incretin agonists (eg byetta), what is the prospect of another K channel antagonist.  The old problems likely will still appear: hypoglycemia, weight gain, and possibly progression of pancreatic failure/cell death.

Analysis: Given the evidence for adverse effects of glinide agents on beta cell function and disease progression, it is risky to push ahead with the idea that a rapid acting K channel antagonist will really compete effectively in the current diabetes arena. Alternative development of the DPP4 and incretin mimetic class is already pushing the glinides aside, and agents that protect beta cell function are also in the pipeline.  Despite the surge in diabetes, the space remains competitive and this agent does not offer a new avenue in therapeutics.