Merck & Co has boosted by the news that European regulators have expanded approval for its diabetes treatment Januvia.

The firm’s Merck Sharp & Dohme unit noted that it has received approval from the European Commission for restricted first-line use of Januvia (sitagliptin) in the treatment of type 2 diabetes. This makes it the only treatment in the dipeptidyl peptidase IV inhibitor (DPP-4) inhibitor class to be licensed to improve glycaemic control when diet and exercise alone are not adequate and when metformin is inappropriate due to contraindications or intolerance.

This new indication follows another approval recently by the Commission in which Janumet (sitagliptin/metformin) may be prescribed in combination with a sulphonylurea and a thiazolidinedione, when diet and exercise plus dual therapy are not effective. Paul Leigh of MSD Diabetes said that broadening the licensed indications “may be particularly important for patients who cannot tolerate established treatments”.

The company will be hoping that the latest approval will further drive forward sales of Januvia. The EC’s decision comes in the wake of recent guidance by the National Institute for Health and Clinical Excellence’s guidelines recommending that DPP-4 inhibitors – such sitagliptin and Novartis’ Vildagliptin – should be considered as a second-line therapy instead of a sulphonylurea when metformin is failing to adequately control blood glucose levels in patients at significant risk of hypoglycaemia.