The Medical Letter on Drugs and Therapeutics
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Saxagliptin/Metformin (Kombiglyze XR) for Type 2 Diabetes

Metformin (Glucophage, and others) is generally preferred as the first-line agent for treatment of type 2 diabetes, but most patients subsequently require treatment with more than one drug.1 Many combination products have been marketed; the latest of these combines saxagliptin2 with extended-release (ER) metformin as Kombiglyze XR.

MECHANISM OF ACTION — Saxagliptin, an oral dipeptidyl peptidase-4 (DPP-4) enzyme inhibitor, slows breakdown of glucagon-like peptide-1 (GLP-1), which increases release of insulin from pancreatic beta cells and decreases release of glucagon from pancreatic alpha cells. Metformin decreases hepatic glucose production and increases insulin sensitivity in peripheral tissues.

CLINICAL STUDIES — Monotherapy vs. Combination Therapy – FDA approval of Kombiglyze XR was based ... more      

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