Clinical use of dipeptidyl peptidase-4 and sodium-glucose cotransporter 2 inhibitors in combination therapy for type 2 diabetes mellitus

Guthrie, Robert

doi:10.1080/00325481.2015.1044756

Cited by 12 publications

(11 citation statements)

References 93 publications

(226 reference statements)

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“…DPP-4i enhance postprandial insulin secretion and suppress glucagon secretion by preventing the degradation of endogenously released incretin hormones [glucagon-like peptide (GLP)-1 and glucose-dependent insulinotropic polypeptide (GIP)], two intestinal peptides whose concentrations physiologically increase after food intake [5]. Of major interest, DPP-4 inhibitors stimulate insulin secretion and inhibit glucagon secretion in a glucose-dependent manner, thus reducing hyperglycaemia while minimizing hypoglycaemia [6].…”

Section: Rationale Of Dpp-4 Inhibitor Plus Sglt2 Inhibitor Combinationmentioning

confidence: 99%

“…Together, DPP-4i and SGLT2i fulfil a need for pharmacological agents with complementary mechanisms of action that can be used in combination to improve glucose control in a wide spectrum of patients with T2D, with a low risk of adverse events, such as hypoglycaemia or weight gain and the potential of cardiovascular protection (Table 1, Figure 1) [5,13,14].…”

Section: Rationale Of Dpp-4 Inhibitor Plus Sglt2 Inhibitor Combinationmentioning

confidence: 99%

“…Thus combination therapy is recommended soon or later in T2D. Various pharmacological approaches may be added to metformin as dual therapies or combined together as triple therapies, among which dipeptidyl peptidase inhibitors (DPP-4i) and/or sodium-glucose cotransporter type 2 inhibitors (SGLT2i) [2][3][4][5].…”

Section: Introductionmentioning

confidence: 99%

“…When one single pharmacological class does not reach HbA1c target as monotherapy or even when added to metformin, a combination of a DPP-4i and a SGLT2i could be helpful in the management of patients with T2D [5,13,14]. Fixed-dose combinations (FDCs) have been recently commercialized, which could facilitate therapy and improve compliance of patients with T2D [15,16].…”

Section: Introductionmentioning

confidence: 99%

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DPP-4 inhibitor plus SGLT-2 inhibitor as combination therapy for type 2 diabetes: from rationale to clinical aspects

Scheen

2016

Expert Opinion on Drug Metabolism & Toxicology

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SUMMARYIntroduction : Type 2 diabetes (T2D) is a complex disease with multiple defects, which generally require a combination of several pharmacological approaches to control hyperglycemia. Combining a dipeptidyl peptidase-4 inhibitor (DPP-4i) and a sodium-glucose cotransporter type 2 inhibitor (SGT2i) appears to be an attractive approach.Area covered: An extensive literature search was performed to analyze the pharmacokinetics, pharmacodynamics and clinical experience of different gliptin-gliflozin combinations.Expert opinion: There is a strong rationale for combining a DPP-4i and a SGLT2i in patients with T2D because the two drugs exert different and complementary glucose-lowering effects.Dual therapy (initial combination or stepwise approach) is more potent than either monotherapy in patients treated with diet and exercise or already treated with metformin.Combining the two pharmacological options is safe and does not induce hypoglycemia. The additional glucose-lowering effect is more marked when a gliflozin is added to a gliptin than when a gliptin is added to a gliflozin. Two fixed-dose combinations (FDCs) are already available (saxagliptin-dapagliflozin and linagliptin-empagliflozin) and others are in current development. Bioequivalence of the two compounds given as FDC tablets was demonstrated when compared with coadministration of the individual tablets. FDCs could simplify the antihyperglycaemic therapy and improve drug compliance. Article highlights box -Type 2 diabetes (T2D) often requires the combination of several medications with complementary actions to reach glucose control targets while limiting side effects -The combination of a dipeptidyl peptidase-4 inhibitor (DPP-4i) and a sodium-glucose cotransporter type 2 inhibitor (SGLT2i) is an attractive approach for the management of T2D. Keywords-Both saxagliptin plus dapagliflozin and linagliptin plus empagliflozin combined therapies have been tested as separate tablets (no clinically relevant pharmacokinetic drug-drug interactions) and as fixed-dose combination (FDC : bioequivalence studies).-DPP-4i -SGLT2i combined therapies are more efficacious than either monotherapy to control blood glucose, without worsening of the safety profile.-Initial DPP-4i -SGLT2i combination may be considered or one compound may the added to the other. However, which one should be used in first place remains an open question.

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Section: Rationale Of Dpp-4 Inhibitor Plus Sglt2 Inhibitor Combinationmentioning

confidence: 99%

Section: Rationale Of Dpp-4 Inhibitor Plus Sglt2 Inhibitor Combinationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

DPP-4 inhibitor plus SGLT-2 inhibitor as combination therapy for type 2 diabetes: from rationale to clinical aspects

Scheen

2016

Expert Opinion on Drug Metabolism & Toxicology

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“…There were studies published that use of DPP-4i in both dual and triple therapy is safe and efficacious option. [20][21][22] …”

Section: Discussionmentioning

confidence: 99%

An Assessment of Anti-hyperglycemic Drug Utilization Patterns and Adherence to AACE/ACE 2015 Guidelines in South Indian Tertiary Care Teaching Hospital

Nuthakki¹,

Pendyala²,

Vallabhu³

et al. 2016

IJOPP

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Aim:To compare adherence to American Association of Clinical Endocrinologists/American College of Endocrinology (AACE/ACE) 2015 guidelines for diabetes care in a tertiary care teaching hospital in India. Method: In this prospective observational study, 415 prescriptions of type 2 diabetes mellitus (T2DM) patients were collected in Dr. Pinnamaneni Siddhartha Institute of Medical Sciences (PSIMS) hospital from January 2015 and June 2015. Medication adherence to AACE/ACE guidelines was assessed based on glycated haemoglobin (HbA1C) values. Results: A total of 201 (48.4%) male and 214 (51.6%) female patients were identified. The mean age was 53.57 ± 10.77 years (male) and 53.69 ± 10.71 years (females). Patients with HbA1C <7.5% (37.3%, male; 45.3%, female) were predominant followed by HbA1C 7.5% -9% (32.3%, male; 35.3%, female) and HbA1C > 9.0% (30.4%, male; 19.2%, female). Hypertension (HTN) (39.8%, male; 39.7%, female) is the most predominant co-morbidity, followed by patients with both HTN and cardio vascular diseases (CVDs) (9.4%, male; 9.8%, female). Insulin was prescribed to control hyperglycaemia in most of the cases (40.0%) followed by dual therapy (26.9%) and triple therapy (17.8%). The overall adherence rate was 88.3% for patients with HbA1C <7.5% (P< 0.0001); 98.7% for patients with HbA1C 7.5%-9%(P<0.0001)and 100% for patients with HbA1C >9%(P<0.0001). Conclusion: Optimal medication adherence is the ultimate goal to control the hyperglycemia in DM. The present study results revealed that the anti-diabetic medication adherence to AACE/ACE 2015 guidelines were optimal by the prescribers.

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Metformin and second- or third-generation sulphonylurea combination therapy for adults with type 2 diabetes mellitus

Madsen

Kähler²,

Kähler

et al. 2019

Cochrane Database of Systematic Reviews

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Clinical use of dipeptidyl peptidase-4 and sodium-glucose cotransporter 2 inhibitors in combination therapy for type 2 diabetes mellitus

Cited by 12 publications

References 93 publications

DPP-4 inhibitor plus SGLT-2 inhibitor as combination therapy for type 2 diabetes: from rationale to clinical aspects

DPP-4 inhibitor plus SGLT-2 inhibitor as combination therapy for type 2 diabetes: from rationale to clinical aspects

An Assessment of Anti-hyperglycemic Drug Utilization Patterns and Adherence to AACE/ACE 2015 Guidelines in South Indian Tertiary Care Teaching Hospital

Metformin and second- or third-generation sulphonylurea combination therapy for adults with type 2 diabetes mellitus

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