Is empagliflozin effective as an add-on therapy in uncontrolled type 2 diabetes?

This study determined the suitability of adding empagliflozin (Jardiance) to the combination of metformin (Glucophage) and linaglipton (Tradjenta) in type 2 diabetes. The authors concluded that adding empagliflozin was effective in patients whose blood sugar was not controlled by the combination of metformin and linaglipton alone.

Linaglipton is one of the potential second-line therapies. This medication improves blood sugar control, without weight gain, and is associated with a low risk of hypoglycemia (dangerously low blood-sugar). Empagliflozin also controls blood-sugar levels with a low risk of hypoglycemia. It is recommended as either a second- or third-line therapy. Whether empagliflozin is effective in patients who are already treated with linagliptin and metformin is under investigation.

This study examined whether the addition of empagliflozin was safe and effective in patients treated with linagliptin and metformin. 606 patients were included in the first phase of the trial. These patients were treated with metformin and linagliptin for 16 weeks. Of these, 327 were included in the second part of the trial. 109 patients added 10 mg of empagliflozin. 110 patients added 25 mg empagliflozin. 108 patients received a placebo (substance with no active effect). HbA1c levels (average blood glucose over 3 months) was measured after 24 weeks.

When compared to the placebo, the use of empagliflozin reduced HbA1c. The lower dose reduced levels by an average of 0.79%. The higher dose reduced levels by an average of 0.70%. Both doses of empagliflozin also reduced fasting blood sugar (blood glucose levels after a period without food or drink) and weight compared to the placebo. More patients receiving placebo reported side effects than those treated with empagliflozin. 

This study concluded that adding empagliflozin to metformin and linagliptin was safe and effective for patients not responding to the two treatments alone.

Larger and longer duration trials are needed to confirm these results.