Patient considerations in type 2 diabetes – role of combination dapagliflozin–metformin XR

PURPOSE: The purpose of this review article is to provide guidance to health care providers regarding the use of dapagliflozin–metformin XR (extended release) as a therapeutic option for the treatment of patients with type 2 diabetes mellitus (T2DM). METHODS: The PubMed database was searched through August 2015 to identify clinical trials and meta-analyses evaluating the use of the sodium–glucose cotransporter type 2 inhibitor dapagliflozin administered as monotherapy or in combination with metformin. RESULTS: Fourteen studies were included for this review, six of which evaluated dapagliflozin in combination with metformin, one of which evaluated dapagliflozin monotherapy, and four of which evaluated dapagliflozin as an add-on therapy to other antidiabetic agents. The combination of dapagliflozin and metformin resulted in an A(1C) decrease of up to 2%, weight loss of 2–3 kg, and modest systolic blood pressure decrease of 3–5 mmHg. However, long-term effects on cancer and cardiovascular health are still being investigated. Providing patients with a fixed-dose combination therapy such as dapagliflozin-metformin XR can increase medication adherence and patient satisfaction, and improve glycemic control. Dapagliflozin–metformin XR is ideal because it can be administered orally once a day, is associated with a low risk of hypoglycemia, and provides the added benefit of weight reduction and modest blood pressure lowering. CONCLUSION: The unique combined mechanism of action and favorable efficacy and safety profile of dapagliflozin–metformin XR support consideration of this fixed-dose combination as a treatment option for patients with T2DM.