Combination treatment of Forxiga (dapagliflozin) and metformin XR (extended release) can lead to reduced blood glucose, blood pressure and enable weight loss among type 2 diabetes patients, a study reports.
Forxiga is an SGLT2 inhibitor that helps lower blood glucose levels; metformin helps diabetic patients respond better to the insulin they produce. The National Institute of Clinical Excellence has approved Forxiga for use alongside metformin in adult patients in England and Wales who cannot tolerate sulphonylureas.
In the UK, an adult patient with type 2 diabetes may be offered dapagliflozi, or another SGLT2 inhibitor, if they take metformin and their HbA1c is above 58 mmol/mol (7.5 per cent).
In this new review, University of Wisconsin-Madison researchers evaluated 14 studies involving people with type 2 diabetes. Six studies analysed dapagliflozin in combination with metformin XR, one evaluated dapagliflozin monotherapy, and four looked at dapagliflozin as an add-on to other anti-diabetic therapies.
Combination therapy of dapagliflozin and metformin led to greater reductions in HbA1c, weight loss and systolic blood pressure compared to monotherapy with either drug.
The researchers noted that fixed-dose combination therapy of dapagliflozin and metformin also increased adherence to medication and patient satisfaction. Additionally, dapagliflozin-metformin can be orally administered once a day, which means it is also associated with a low risk of hypoglycemia.
However, the researchers added that “no single therapy fits every patient and underscores the need to individualise anti-diabetic therapy based on the specific characteristics of the patient.” They also noted that long-term effects on cancer and cardiovascular health as a result of dual therapy are still being investigated.
The findings were published in the online journal Dove Medical Press.

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