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Aim: To evaluate the efficacy and safety of retagliptin in Chinese patients with type 2 diabetes (T2D) inadequately controlled with metformin. Materials and Methods: This multicentre, phase 3 trial consisted of a 16‐week, randomized, double‐blind, placebo‐controlled period, where patients with HbA1c levels between 7.5% and 11.0% were randomized to receive either once‐daily (QD) retagliptin 100 mg (n = 87) or placebo (n = 87), both as an add‐on to metformin. The primary endpoint was the change in HbA1c from baseline to week 16. Results: At week 16, the least squares mean change in HbA1c from baseline, compared with placebo, was −0.82% (95% CI, −1.05% to −0.58%) for the retagliptin 100 mg QD group (P <.0001) per treatment policy estimand. Significantly higher proportions of patients in the retagliptin 100 mg QD group achieved HbA1c levels of less than 6.5% (11.5%) and less than 7.0% (26.4%) compared with those receiving placebo (0% and 4.6%; P =.0016 and P <.0001, respectively) at week 16. Retagliptin 100 mg QD also lowered fasting plasma glucose and 2‐hour postprandial plasma glucose levels. The incidence of adverse events (AEs) during the treatment period was similar between the two groups. However, slightly higher proportions of increased lipase and increased amylase in the retagliptin 100 mg QD group were observed. No patients discontinued treatment permanently because of AEs, and no episodes of severe hypoglycaemia were reported. Conclusions: Retagliptin 100 mg QD as an add‐on therapy to metformin offers a new therapeutic option for treating Chinese patients with T2D inadequately controlled by metformin alone, and is generally well tolerated. [ABSTRACT FROM AUTHOR]

The cover image is based on the Original Article Retagliptin as add‐on therapy to metformin in Chinese patients with type 2 diabetes inadequately controlled with metformin: A multicentre, randomized, double‐blind, placebo‐controlled, phase 3 trial by Lixin Guo MD et al., https://doi.org/10.1111/dom.15601..By Lixin Guo; Fengsheng Tian; Li Liu; Mingwei Chen; Chengxia Jiang; Shuangqing Li; Cong Liu; Yawei Zhang; Jie Qin; Dongni Yu; Yicen Zong and Wei DaiReported by Author; Author; Author; Author; Author; Author; Author; Author; Author; Author; Author; Author [Extracted from the article]

Aims/Introduction: Despite increasing interest in growth differentiation factor 11 (GDF11) based on its involvement in age‐related disorders, clinical implications – especially for metabolic diseases – remain unclear. Therefore, we assessed the association between serum GDF11 levels and metabolic disturbance in the Chinese population. Materials and Methods: A total of 381 individuals from the Shanghai Nicheng Cohort Study were included. In addition to anthropometry, laboratory and ultrasonography measurements, serum concentrations of GDF11 were measured by enzyme‐linked immunosorbent assay. Results: Circulating GDF11 concentrations were unchanged with age (r = –0.064, P = 0.210), but showed an inverse relationship to body mass index, waist circumference and fat‐free mass index (all P < 0.05). Correlation analysis showed decreased GDF11 concentrations accompanied by elevated diastolic blood pressure, fasting and 2‐h plasma glucose, triglycerides, and low‐density lipoprotein cholesterol after adjusting for sex, age and body mass index, whereas variations in aspartate aminotransferase and free thyroxine were consistent with GDF11 (all P < 0.05). Furthermore, people, especially men, with abnormal glycometabolism, body mass index and/or fat accumulation in the liver had lower serum levels of GDF11 (P < 0.05); an increase in metabolic syndrome morbidity along with the circulatory decline of GDF11 was found when stratified by GDF11‐level quartiles (P‐trend <0.001). Logistic regression showed that serum GDF11 levels were independently correlated with the presence of metabolic syndrome (odds ratio 0.665, 95% confidence interval 0.510–0.867, P = 0.003). Conclusions: We confirmed GDF11 as an endocrine factor playing a significant role in multiple metabolic processes and an indicator of metabolic syndrome in the Chinese population, particularly in males. [ABSTRACT FROM AUTHOR]