Cofrogliptin once every 2 weeks as add-on therapy to metformin versus daily linagliptin in patients with type 2 diabetes in China: A randomized, double-blind, non-inferiority trial

Diabetes Obes Metab. 2024 Nov;26(11):5013-5024. doi: 10.1111/dom.15915. Epub 2024 Sep 23.

Abstract

Aim: We evaluated the efficacy and safety of cofrogliptin, a novel dipeptidyl peptidase-4 inhibitor taken once every 2 weeks (Q2W), compared with linagliptin (taken daily) in patients with type 2 diabetes inadequately controlled on metformin in China.

Materials and methods: In this phase 3 randomized, double-blind, active-controlled, multicentre study, patients were randomly assigned 1:1:1 to receive cofrogliptin 10 mg Q2W, cofrogliptin 25 mg Q2W, or linagliptin 5 mg daily, all as an add-on treatment to metformin, for 24 weeks. Eligible patients could enter an open-label extension period and receive cofrogliptin 25 mg Q2W for an additional 28 weeks. The primary endpoint was change in glycated haemoglobin from baseline to 24 weeks, with a non-inferiority margin of 0.4% for cofrogliptin versus linagliptin treatment.

Results: Overall, 465 patients entered the 24-week treatment period (median age: 57.0 years). The least-squares mean (standard error) change in glycated haemoglobin from baseline to week 24 was -0.96 (0.063), -0.99 (0.064) and -1.07 (0.065) for the cofrogliptin 10 mg, cofrogliptin 25 mg and linagliptin 5 mg groups, respectively. The between-group difference met the predefined margin for non-inferiority of cofrogliptin (10 and 25 mg) versus linagliptin treatment. The incidence of common adverse events (≥5% patients) during the 24-week treatment period was similar between treatment groups. There were no serious hypoglycaemic events.

Conclusion: In Chinese patients with type 2 diabetes inadequately controlled on metformin, the glucose-lowering effect of cofrogliptin (Q2W) was non-inferior to linagliptin (daily), with a similar safety profile maintained over 52 weeks of treatment.

Keywords: antidiabetic drug; clinical trial; dipeptidyl peptidase‐4 inhibitor; glycaemic control; linagliptin; type 2 diabetes.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Clinical Trial, Phase III
  • Equivalence Trial
  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Blood Glucose / drug effects
  • Blood Glucose / metabolism
  • China / epidemiology
  • Diabetes Mellitus, Type 2* / blood
  • Diabetes Mellitus, Type 2* / drug therapy
  • Dipeptidyl-Peptidase IV Inhibitors* / administration & dosage
  • Dipeptidyl-Peptidase IV Inhibitors* / therapeutic use
  • Double-Blind Method
  • Drug Administration Schedule
  • Drug Therapy, Combination*
  • Female
  • Glycated Hemoglobin* / analysis
  • Glycated Hemoglobin* / drug effects
  • Glycated Hemoglobin* / metabolism
  • Humans
  • Hypoglycemia / chemically induced
  • Hypoglycemia / epidemiology
  • Hypoglycemia / prevention & control
  • Hypoglycemic Agents* / administration & dosage
  • Hypoglycemic Agents* / therapeutic use
  • Linagliptin* / administration & dosage
  • Linagliptin* / therapeutic use
  • Male
  • Metformin* / administration & dosage
  • Metformin* / therapeutic use
  • Middle Aged
  • Treatment Outcome

Substances

  • Linagliptin
  • Metformin
  • Hypoglycemic Agents
  • Dipeptidyl-Peptidase IV Inhibitors
  • Glycated Hemoglobin
  • Blood Glucose
  • hemoglobin A1c protein, human