Doctors in the UK now have a new option to treat patients whose diabetes remains uncontrolled following yesterday’s launch of Merck Sharp & Dohme’s combo pill Janumet.

Janumet is a fixed combination of the firm’s diabetes drug sitagliptin (a DPP-4 inhibitor, sold under the brand name Januvia) and metformin (the gold standard treatment) housed in a single pill, which has been approved for use by the 27 member countries of the European Union to improve glycaemic control in patients with type 2 diabetes.

Specifically, the drug can be used as an adjunct to diet and exercise in patients whose blood sugar levels are inadequately controlled by metformin alone or metformin and a sulphonylurea, or those already being treated with the combination of the drugs.

According to the firm, Janumet effectively targets the three core defects underlying diabetes - insulin deficiency, insulin resistance and over production of glucose – whilst offering a reduced risk of hypoglycaemia and weight gain, side effects often seen with other treatments for the disease.

The drug has certainly demonstrated its potential in helping patients achieve better control of blood sugar levels in clinical trials. For one, the results of a 30-week, placebo-controlled clinical study showed that adding sitagliptin to metformin boosted the likelihood of reaching target levels of the blood glucose marker HbA1c at 18 weeks (13.7%) and 30 weeks (22.1%) compared with placebo (3.3%).

In addition, as the therapy cuts down on the number of pills patients need to take to lower their blood sugar, it is hoped that Janumet will help to boost treatment compliance and therefore generate better outcomes. According to the results of a survey undertaken on behalf of MSD, 42% of GPs in the UK say the primary issue of concern raised by their patents is forgetting to take medicines, and 91% believe that that pill burden affects treatment compliance, so Janumet could offer an important benefit in addressing these issues.

Optimising choice
Interestingly, MSD’s survey also revealed that nearly a quarter of GPs (23%) were unaware of which diabetes therapy targets which underlying cause of the disease, and as Janumet targets all three it could help to “optimise treatment choices” for doctors, the firm said.

“The availability of sitagliptin/metformin in the UK is a significant advance, bringing together two effective treatment options that are already being widely used first and second-line in the treatment pathway,” commented Professor Anthony Barnett, Heart of England NHS Foundation Trust.