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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EOver a 24-week period, a combination of empagliflozin\/linagliptin for the treatment of type 2 diabetes produced significant reductions in HbA\u003Csub\u003E1c\u003C\/sub\u003E compared with linagliptin and with empagliflozin 10 mg, but not empagliflozin 25 mg. This randomized trial suggests that this approach could be a more efficient way to achieve glycemic control.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003Elinagliptin\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eempagliflozin\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ediabetes mellitus\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EDPP-4 inhibitor\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ESGLT2 inhibitor\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EHbA\u003Csub\u003E1c\u003C\/sub\u003E\n            \u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eincretin peptides\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EGLP-1\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eglucagon\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eendocrinology, diabetes \u0026amp; metabolism clinical trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ehyperglycemia\/hypoglycemia\u003C\/li\u003E\u003C\/ul\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\n         \n         \u003Cp id=\u0022p-2\u0022\u003EOne tablet of empagliflozin and linagliptin significantly reduced HbA\u003Csub\u003E1c\u003C\/sub\u003E in patients with type 2 diabetes. Andrew J. Lewin, MD, National Research Institute, Los Angeles, California, USA, and colleagues conducted a randomized, double-blind, parallel-group, phase 3 study, the Safety and Efficacy of the Combination of Empagliflozin and Linagliptin Compared to Linagliptin Alone Over 24 Weeks in Patients With Type 2 Diabetes study [Lewin A et al. \u003Cem\u003EDiabetes Care\u003C\/em\u003E. 2015].\u003C\/p\u003E\n         \u003Cp id=\u0022p-3\u0022\u003EEmpagliflozin reduces renal glucose reabsorption, thereby increasing urinary glucose excretion. This leads to a decline in plasma glucose levels in an insulin-independent manner [Heise T et al. \u003Cem\u003EDiabetes Obes Metab\u003C\/em\u003E. 2013]. Linagliptin prevents the inactivation of incretin peptides, such as glucagon-like peptide-1 (GLP-1), stimulates insulin release, and inhibits glucagon secretion [Gallwitz B. \u003Cem\u003EDiabetes Metab Syndr Obes\u003C\/em\u003E. 2013]. Each drug is an FDA-approved treatment for patients with type 2 diabetes. As compared with the single agent treatment groups, those treated with the dual combination achieved lower A\u003Csub\u003E1c\u003C\/sub\u003E levels.\u003C\/p\u003E\n         \u003Cp id=\u0022p-4\u0022\u003EEfficacy was evaluated in 667 patients who had not received antihyperglycemic therapy for \u2265\u200512 weeks. Their mean (standard deviation) age was 54.6 (10.2) years; mean weight was 87.9 (20.1) kg; average body mass index was 31.6 (5.6) kg\/m\u003Csup\u003E2\u003C\/sup\u003E; and mean HbA\u003Csub\u003E1c\u003C\/sub\u003E level was 8.02% (0.96). Baseline characteristics were balanced between treatment groups.\u003C\/p\u003E\n         \u003Cp id=\u0022p-5\u0022\u003EPatients were randomized (1:1:1:1:1) to receive empagliflozin 25 mg\/linagliptin 5 mg as a fixed-dose combination (FDC) tablet; empagliflozin 10 mg\/linagliptin 5 mg as an FDC tablet; empagliflozin 25 mg; empagliflozin 10 mg; or linagliptin 5 mg for 52 weeks. The primary end point was the change from baseline in HbA\u003Csub\u003E1c\u003C\/sub\u003E at week 24.\u003C\/p\u003E\n         \u003Cp id=\u0022p-6\u0022\u003EAt week 24, reductions from baseline in HbA\u003Csub\u003E1c\u003C\/sub\u003E were significantly greater for empagliflozin 25 mg\/linagliptin 5 mg compared with linagliptin 5 mg (\u003Cem\u003EP\u003C\/em\u003E\u2005\u0026lt;\u2005.001), but not compared with empagliflozin 25 mg (\u003Cem\u003EP\u003C\/em\u003E\u2005\u0026lt;\u2005.179), and were significantly greater for empagliflozin 10 mg\/linagliptin 5 mg compared with individual doses (\u003Cem\u003EP\u003C\/em\u003E\u2005\u0026lt;\u2005.001 for both). At week 24, 55.4% of patients with baseline HbA\u003Csub\u003E1c\u003C\/sub\u003E\u2005\u2265\u20057% reached HbA\u003Csub\u003E1c\u2005\u003C\/sub\u003E\u0026lt;\u20057% with empagliflozin 25 mg\/linagliptin 5 mg; 62.3% did so with empagliflozin 10 mg\/linagliptin 5 mg; 41.5% with empagliflozin 25 mg; 38.8% with empagliflozin 10 mg; and 32.3% with linagliptin 5 mg. Efficacy was maintained at week 52.\u003C\/p\u003E\n         \u003Cp id=\u0022p-7\u0022\u003EThe proportion of patients with adverse events over this time was similar across groups (68.9% to 81.5%), with no confirmed hypoglycemic adverse events in either combination group. Empagliflozin\/linagliptin was well-tolerated, with an overall safety profile similar to those of the individual drugs.\u003C\/p\u003E\n         \u003Cp id=\u0022p-8\u0022\u003EThis was the first randomized controlled trial to evaluate the efficacy and safety of the initial combination of a sodium-glucose cotransporter 2 (SGLT2) inhibitor (empagliflozin) and a DPP-4 inhibitor (linagliptin) in patients with type 2 diabetes.\u003C\/p\u003E\n      \u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2015 SAGE Publications\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/15\/4\/14.1.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzlmuq\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}