2016
DOI: 10.1007/s40262-016-0498-9
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Pharmacokinetic Characteristics and Clinical Efficacy of an SGLT2 Inhibitor Plus DPP-4 Inhibitor Combination Therapy in Type 2 Diabetes

Abstract: SUMMARYType 2 diabetes (T2D) generally requires a combination of several pharmacological approaches to control hyperglycaemia. Combining a sodium-glucose cotransporter type 2 inhibitor (SGLT2i, known as gliflozin) and a dipeptidyl peptidase-4 inhibitor known as gliptin) appears to be an attractive strategy because of complementary modes of action.This narrative review analyzes the pharmacokinetics and clinical efficacy of different combined therapies with a SGLT2i (canagliflozin, dapagliflozin, empaglifloz… Show more

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Cited by 33 publications
(15 citation statements)
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“…The half life of this class of agents is approximately 13 hours, but the clinical effect can last for several days after discontinuation 475093. Patients need to be educated about situations that predispose them to developing euglycemic diabetic ketoacidosis, including dehydration or ingestion of excessive amounts of alcohol 54750.…”
Section: Prevention Of Diabetic Ketoacidosis and Hhsmentioning
confidence: 99%
“…The half life of this class of agents is approximately 13 hours, but the clinical effect can last for several days after discontinuation 475093. Patients need to be educated about situations that predispose them to developing euglycemic diabetic ketoacidosis, including dehydration or ingestion of excessive amounts of alcohol 54750.…”
Section: Prevention Of Diabetic Ketoacidosis and Hhsmentioning
confidence: 99%
“…The study of the concurrent use of DPP-4I and SGLT2-I treatment showed that monotherapy was more effective in patients treated with metformin, when a gliptin was added to gliflozin, it was determined that it had the effect of more glucose lowering than when a gliflozin was added to gliptin. The opinion at the end of the meta-analysis is that SGLT2I and DPP-4I can be used as an initial combination or as a gradual approach and combining two pharmacological options is safe and does not induce hypoglycemia[ 44 ]. Furthermore, when the sum of the evidence for the use of dapagliflozin is assessed, it has not been shown that there is a causal relationship between dapagliflozin and bladder cancer, which was previously proposed[ 45 ].…”
Section: Incretin Based Medicationsmentioning
confidence: 99%
“…Further, patients who achieve glycaemic control with dual therapy may experience progressive deterioration of glycaemic control. In some cases, it may be appropriate to consider addition of a combination of two anti‐hyperglycemic agents (AHAs) with complementary mechanisms of action, favourable safety profiles and without pharmacokinetic interaction, such as a sodium‐glucose cotransporter 2 (SGLT2) and dipeptidyl peptidase‐4 (DPP‐4) inhibitors . This may provide a more robust and sustained anti‐hyperglycaemic effect, resulting in more patients achieving and maintaining glycaemic goals, and could become a useful alternative to the single stepwise anti‐hyperglycaemic approach.…”
Section: Introductionmentioning
confidence: 99%