Summary
Saxagliptin, perhaps the DPP-IV inhibitor with the best name is on the verge of being granted a license in Europe. This will be the third DPP-IV inhibitor available for use in Europe, and is likely to have the same blip in use followed by a prolonged lull whilst the wait for long-term safety data takes place. Like all new drugs for type 2 diabetes mellitus, it has the magic 1% HbA1c reduction, and short-term safety data, but like all the rest from SU's to insulin the long-term data is modest, scant or lacking. As Lantus takes a hit from authors suggesting a cancer link, the time for novel agents which are at least as good as once daily insulin is here. Without evidence of durable effect however, is Saxagliptin or its cousins the answer. Unfortunately the wait might betoo long to bear.
Analysis
Astra-Zeneca and BMS havew added the 3rd in class DPP-IV inhibitor. One is already unlicensed in the US and concerns about heart failure risk persist. Merck may be concerned if A-Z do the usual good job of safety testing and it turns out clean, as they have the market and are likely to be the one to enter into proper competition.
A major stumbling block in the UK will be MHRA and NICE - both of these move slowly on Guidance and the next review of type 2 Diabetes Mellitus is some time away.
