Combination therapy with saxagliptin and dapagliflozin for the treatment of type 2 diabetes

Introduction: Sodium glucose co-transporter 2 (SGLT2) inhibitors such as dapagliflozin and dipeptidyl peptidase-4 (DPP-4) inhibitors such as saxagliptin have the potential to confer significant benefits in glycemic control without the risk of weight gain and hypoglycemia, which may be associated with other medications used to treat type 2 diabetes.Areas covered: This review examines the current available literature on the combination of saxagliptin and dapagliflozin as a treatment option, which is likely to be available as a fixed-dose combination in 2016. We reviewed the available published literature along with recently published abstracts examining the combination of these agents in relation to glycemic control, weight and blood pressure reduction, and adverse effects.Expert opinion: To date, the limited literature suggests that the combination of saxagliptin and dapagliflozin is associated with significant improvements in glycated haemoglobin, fasting and postprandial glucose levels with few adverse effects. The combination appears to be well tolerated with low rates of hypoglycemia, urinary tract, and genital infections. Combination therapy may also be associated with improved beta-cell function and enhanced insulin clearance in addition to their established underlying mechanisms of action. Further publications of ongoing trials and abstracts should further support its clinical role.