Summary
After years of riding the crest of the PROACTIVE wave, Takeda now has to take a number and wait to see if Alogliptin can join the DPP-IV bandwagon. Novartis have struggled and taken their foot of the gas in the USA with Vildagliptin, so a CVS clean DPP-IV competitor for Merck's Sitagliptin would be a welcome addition. Whilst other regions will do their own thing, these ripples will still be felt in the UK, Europe and beyond. From the UK perspective, these drugs are still relatively small players, but if genuine CVS benefits, rather than just helpful neutrality, can be shown, then they have a future.
Analysis
Takeda benefited from GSK's mauling by "that" NEJM meta-analysis. Flawed or otherwise, it put Actos front stage as the "safe" TZD for use in type 2 Diabetes Mellitus. Of course the zeitgeist is always moving and DPP-IV are the new flavour for type 2 Diabetes Mellitus - probably. Takeda will hope they can pull off another PRoActive but the FDA will want a better study than that, and Takeda will need to sweat it out.
