In a nutshell
This study evaluated the safety of a combination of empagliflozin (Jardiance) and linagliptin (Tradjenta) compared to either drug on its own, in people with type 2 diabetes (T2D). It was determined that the combination was as safe as either drug alone.
Some background
Metformin (Glucophage) is usually the first drug given to people with T2D. However, since T2D is a chronic condition, as it progresses more than one medication is often needed to control blood glucose (sugar) levels.
Empagliflozin is a SGLT2 inhibitor. SGLT2 inhibitors prevent glucose from re-entering the bloodstream from the kidneys. Linagliptin is a DPP4 inhibitor. DPP4 inhibitors help to stimulate the release of insulin (the hormone that lowers blood glucose) and inhibit the release of glucagon (the hormone that raises blood glucose).
Previous research suggests that a combination of empagliflozin and linagliptin may be better at controlling blood glucose than either drug on its own, when added to metformin. However, the safety and side effects of the combination are still under investigation.
Methods & findings
This study examined data from 2 other studies. 1363 adults with T2D participated. 545 received a combination of empagliflozin and linagliptin. 551 received empagliflozin only. 267 received linagliptin only. 686 participants also received metformin, and 677 did not. They were followed-up for 1 year.
Side effects occurred in 72.3% of the combination group, 73% of the empagliflozin group, and 70.4% of the linagliptin group. Most side effects were mild or moderate. Serious side effects occurred in 5.1% of the combination group, 6.3% of the empagliflozin group, and 3.7% of the linagliptin group.
Urinary tract infections (UTIs) were the most common side effects. They occurred in 11.9% of the combination group, 12.9% of the empagliflozin group, and 12.7% of the linagliptin group. UTIs were more common in women (22%) than men (4.3%). Genital infections occurred in 4.2% of the combination group 6.5% of the empagliflozin group, and 2.6% of the linagliptin group.
Hypoglycemia (dangerously low blood glucose) was rare, and occurred at similar rates in all groups. 1.5% of the combination group, 2.2% of the empagliflozin group, and 1.5% of the linagliptin group experienced hypoglycemia. The risks of allergic reactions, dehydration, pancreatitis, and reduced kidney function, were low and similar in all groups.
Total cholesterol (good and bad) increased slightly in the combination group and the empagliflozin group, and decreased slightly in the linagliptin group. HDL cholesterol (good cholesterol) increased slightly in all groups.
The bottom line
The study concluded that the risks of side effects were similar with a combination of empagliflozin and linagliptide and with either drug on its own, with or without metformin.
The fine print
This study was funded by Boehringer Ingelheim & Eli Lilly and Company, the manufacturers of empagliflozin and linagliptin.
What’s next?
Discuss with your physician the risks and benefits of combining different medications.
Published By :
Advances in therapy
Date :
Jun 15, 2018
