Saxagliptin as an add-on treatment in type 2 diabetes

The authors aimed to determine the safety and efficacy of saxagliptin (Onglyza) as an add-on treatment in patients with type 2 diabetes already receiving treatment with dapagliflozin (Farxiga) and metformin (Glucophage).

The authors concluded that using saxagliptin as an add-on treatment for 52 weeks resulted in improvements in blood sugar control without an increase in body weight or an increased risk of hypoglycaemia (deficiency of sugar in the blood).

Metformin is the standard treatment used to control blood glucose levels in type 2 diabetes. However, other medications must often be added. Dapagliflozin is a therapy that increases the amount of glucose excreted through urine. Saxagliptin functions by increasing the amount of insulin produced by the body after meals when the blood sugar levels are high. Because these treatments work in different ways, it is thought that the combination will be effective at lowering blood sugar levels.

The aim of this study was to determine the effect of saxagliptin when used in combination with metformin and dapagliflozin to treat type 2 diabetes. 

315 patients were used in this study (an extension of a prior study). Patients who were receiving dapagliflozin and metformin were randomly assigned to receive either saxagliptin (group 1) or a placebo (substance with no effect on the body, group 2). Patients were treated for 52 weeks.

Patients in group1 experienced an improvement in blood sugar control and HbA1c (average blood sugar over 3 months) levels at 52 weeks from baseline compared to group 2. A larger number of patients achieved HbA1c levels of less than 7% in group 1 (29%) compared to group 2 (13%). Fewer patients discontinued treatment due to lack of blood sugar control in group 1 (19%) compared to group 2 (28%). Both groups experienced similar weight reductions from the start of treatment to 52 weeks. Rates of dangerously low blood sugar (hypoglycemia) were low in both groups.

The occurrence of treatment side effects were similar between both groups. The most common side effects were kidney infections, headaches, diarrhea and common cold symptoms. The incidence of genital infections was 3.3% in group 1. This was compared to 6.2% in group 2.

The authors concluded that adding saxagliptin to dapagliflozin and metformin for 52 weeks resulted in improvements in blood sugar control without an increase in body weight or an increased risk of hypoglycemia.

This study was funded by Bristol-Myers Squibb and AstraZeneca.