Pharmacogenetic aspects of vildagliptin treatment in patients with newly diagnosed type 2 diabetes mellitus

Objective: to study a role of the rs5219 polymorphism in KCNJ11 in the formation of the response variability to vildagliptin therapy in patients with newly diagnosed type 2 diabetes mellitus (T2DM).

Materials and methods: 48 patients with newly diagnosed T2DM were examined. For all patients vildagliptin in a dose of 50 mg/day was prescribed. If necessary, dose titration was carried out or other glucose-lowering therapy was prescribed for 6 months of observation. Dynamics of the main indicators of glycemic control and body mass index were studied, presence of the rs5219 polymorphism in KCNJ11 gene was also determined.

Results: all patients-carriers the T allele had achieved the target values of glycated hemoglobin (HbA1c) in 3 months of vildagliptin monotherapy, compared to patients with wild-type gene who achieved target values of HbA1c in only 44,4% of cases. Increasing the dose to 100 mg/day required 35% of patients with wild-type gene and 17.9% of patients with rs5219 polymorphism. The appointment of a combination of glucose-lowering therapy was necessary in 40% of patients with the wild-type gene and no one with polymorphism.

Conclusion: the presence of the polymorphic allele T rs5219 in KCNJ11 gene makes it possible to predict the high efficacy of vildagliptin monotherapy in patients with newly diagnosed T2DM.

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