Effect of saxagliptin as add-on therapy in patients with poorly controlled type 2 diabetes on insulin alone or insulin combined with metformin

Abstract

Saxagliptin 5-mg once-daily add-on therapy improves glycemic control in T2D patients on insulin alone or combined with metformin and is generally well-tolerated. NCT00757588.

Dual Add-on Therapy in Type 2 Diabetes Poorly Controlled With Metformin Monotherapy: A Randomized Double-Blind Trial of Saxagliptin Plus Dapagliflozin Addition Versus Single Addition of Saxagliptin or Dapagliflozin to Metformin

“…The mechanisms of action of saxagliptin and dapagliflozin are complementary to that of metformin, and both have a low risk of hypoglycemia and are weight neutral (saxagliptin) or produce reductions in body weight (dapagliflozin) (9,10). In previous studies in patients with type 2 diabetes, saxagliptin and dapagliflozin improved glycemic control and were well tolerated when used as monotherapy (11)(12)(13) or as add-on therapy to commonly used OADs (14)(15)(16)(17)(18)(19)(20) and insulin (21,22).…”

Type 2 Diabetes Treatment Recommendations Update: Appropriate Use of Dipeptidyl Peptidase-4 Inhibitors

“…The addition of exenatide reduced the daily insulin requirements without increasing the incidence of hypoglycemia. Similarly, DPP-4 inhibitors added to insulin therapy (with or without metformin and/or pioglitazone) produced greater reductions in A1C (sitagliptin, saxagliptin, linagliptin, and alogliptin) and PPG (sitagliptin, saxagliptin, and linagliptin) than ongoing treatment with the insulin regimen alone [72][73][74]103]. Changes in body weight were similar between the groups taking insulin without versus with DPP-4 inhibitors.…”

“…Sitagliptin, saxagliptin, linagliptin, and alogliptin are DPP-4 inhibitors approved for use in the United States. DPP-4 inhibitors effectively improve glycemic control (significantly reduce A1C, FPG, and PPG [when measured]) when used as monotherapy [56][57][58][59], as add-on to metformin [60][61][62][63][64], as add-on to SUs with or without metformin [65][66][67][68], as add-on to TZDs with or without metformin [69][70][71], as add-on to insulin with or without metformin [72][73][74], and as initial combination with metformin [75] or pioglitazone [76][77][78]. As monotherapy, reductions in A1C with DPP 4 inhibitors are generally less than those with agents that primarily target FPG, such as metformin or long-acting GLP-1 receptor agonists, but are comparable to those with SUs and TZDs [79].…”

“…DPP-4 inhibitors are weight neutral and pose a low risk of hypoglycemia when used as monotherapy [56][57][58][59] or as add-on to metformin [60][61][62][63][64]. When added to insulin therapy, they have the potential to lower daily insulin requirements [72]. When DPP-4 inhibitors are used in combination with an insulin secretagogue (eg, SU) or insulin, a lower dose of the insulin secretagogue or insulin may be required to reduce the risk of hypoglycemia [80].…”

Saxagliptin Responder Analysis: A Pooled Analysis of 5 Clinical Trials

“…In phase 3 clinical trials, saxagliptin, when used as monotherapy [9,10] or as add-on therapy [11][12][13][14] in patients with T2DM, improves glycemic control and has a favorable safety and tolerability profile [15]. Saxagliptin also is weight neutral and has a low propensity for hypoglycemia, except when used with insulin or sulfonylureas [11,12]. Furthermore, data from the SAVOR cardiovascular outcomes study suggest that saxagliptin may reduce the usual decline in β-cell function in T2DM, thereby slowing diabetes progression [16].…”