Dapagliflozin combination therapy in type 2 diabetes mellitus

Abstract

Type 2 diabetes mellitus (T2DM) is a progressive disease, and most patients ultimately require two or more antidiabetes drugs in addition to lifestyle changes to achieve and maintain glycemic control. Current consensus statements and guidelines recommend metformin as first-line pharmacotherapy for the treatment of T2DM in most patients. When glycemic control cannot be maintained with metformin alone, the sequential, stepwise addition of other agents is recommended. Agents such as thiazolidinediones or sulfonylureas have typically been added to metformin therapy. Although effective in reducing glycated hemoglobin, these drugs are often associated with adverse effects, most notably weight gain, and in the case of sulfonylureas, hypoglycemia. Sodium-glucose cotransporter 2 inhibitors, such as dapagliflozin, are the newest class of antidiabetes drugs approved for the treatment of T2DM. Dapagliflozin effectively improves glycemic control by increasing the renal excretion of excess glucose. In clinical trials, dapagliflozin has been well tolerated and has additional benefits of weight loss, low risk of hypoglycemia and reduction in blood pressure. This review discusses the clinical evidence and rationale for the use of dapagliflozin as add-on therapy in T2DM. The results suggest that dapagliflozin add-on therapy is a promising new treatment option for a wide range of patients with T2DM. Results from an ongoing cardiovascular outcomes trial are needed to establish the long-term safety of dapagliflozin.

Efficacy of Dapagliflozin in Patients with Diabetes Mellitus Complicated with Coronary Artery Disease and Its Impact on the Vascular Endothelial Function

“…The RHI is an established indicator of vascular endothelial function. The present study found that abnormal endothelial function (RHI < 1:67 ) was still found in about 40% of the elderly population with diabetes mellitus complicated by coronary artery disease; most of whom were treated with related medications, which indicates the modest effects of conventional drugs on the improvement of vascular endothelial function [14][15][16][17]. Moreover, dapagliflozin herein was associated with fewer patients with abnormal RHI after treatment, which is suggestive of the benefits of dapagliflozin in vascular endothelial function [18][19][20].…”

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“…INTRODUCTION: 1,2 Type 2 diabetes affects millions of people worldwide, and India is suspected of being the world's diabetes capital with 72.94 million cases in 2017. Metformin is considered a first-line treatment for type 2 diabetes, followed by sulfonylureas.…”

Validation of Stability-Indicating Reverse Phase HPLC Method for the Determination of Related Substances in Dapagliflozin Drug Substance

“…The clinical research results suggest that dapagliflozin add-on therapy is a promising new treatment option for a wide range of patients with T2DM. Results from an ongoing cardiovascular outcomes trial are needed to establish the long-term safety of dapagliflozin [1][2][3].…”