Comparison of the Efficacy of Once Weekly Dose of Trelagliptin Versus Once Daily Dose of Vildagliptin on the Levels of HbA1c in Type-2 Diabetes Patients

Once-weekly dipeptidyl peptidase-4 inhibition represents a potential strategy to reduce dosing burden while maintaining glycaemic efficacy in type 2 diabetes mellitus. Objectives: To compare once-weekly trelagliptin with once-daily vildagliptin in adults receiving background metformin, using change in glycated hemoglobin and attainment of glycated hemoglobin below 7%, with secondary assessment of body weight and body mass index. Methods: A randomized, open-label, parallel-group clinical trial was conducted at a tertiary care hospital. Adults aged 30 to 60 years with type 2 diabetes mellitus, glycated hemoglobin 7.5% to 9.5% on metformin, were randomized by lottery to trelagliptin 100 mg once weekly or vildagliptin 50 mg once daily for 12 weeks. Independent-samples t testing and chi-square or Fisher's exact testing were applied as appropriate. Prespecified stratified analyses were performed for the efficacy endpoint. Results: A total of 102 participants were randomized, and 93 completed follow-ups. Baseline characteristics were comparable. Glycated hemoglobin change was −1.24±0.78% with trelagliptin and −1.52±0.67% with vildagliptin, mean difference 0.28% (95% CI −0.02 to 0.58), p=0.068. Target attainment was 53.2% versus 63.0%, p=0.336. Weight and body mass index changes did not differ significantly, and stratified analyses showed no significant subgroup effects. Conclusions: No statistically significant difference was detected between once-weekly trelagliptin and once-daily vildagliptin in glycaemic improvement over 12 weeks in patients. Short-term changes in body weight and body mass index were also not significantly different between the two treatment groups.