Glyxambi in Real World Indian Type 2 Diabetes Patient (GRID)
Randomized clinical trials (RCTs) have provided evidence for the use of combination therapy with oral anti-diabetic medications i.e. SGLT-2i (Sodium-glucose cotransporter 2 inhibitors) and DPP-4i (Dipeptidyl peptidase-4 inhibitors). Yet, there is a lack of real-world evidence for the same. Kovil and colleagues (2020) have conducted an observational study to provide evidence for the “Effect of Glyxambi in Real World Indian Type 2 Diabetes Patient (GRID)” published in The Journal of the Association of Physician of India. Summary of the studies is provided below:
Objective:
To generate real-world evidence for glyxambi in the Indian population.
Method:
251 participated patients were followed up for 24 weeks between August 2018 to January 2019. Patients were segregated into four categories as mentioned below, after initiating a fixed-dose combination (FDC) of Empagliflozin and Linagliptin.
1. Patients naïve to DPP-4i or SGLT-2i use
2. Patients previously using DPP-4i
3. Previous users of SGLT-2i
4. Patients already using SGLT-2i and DPP-4i individually being switched over to the FDC
Clinical parameters to track changes in glycemia, body weight, and blood pressure are recorded.
Findings:
As observed in RCTs, real-world use of combination therapy also reported a similar effect. There was an improvement in medication adherence when these two individual agents i.e. Empaglifozin and Linagliptin is replaced by FDC. The study covered a broad range of patients including those using antidiabetic therapy as well as those with comorbid cardiovascular risk. Therefore, the results can be generalized to a broader population for its effectiveness. Additionally, the study also provides insight for benefit of combination therapy in reducing weight and blood pressure.
Limitation:
Authors acknowledge future studies for combination therapy in relation to the reduction of genitourinary infection. Future real-world studies with a larger sample size might add value to existing evidence as per the researchers.
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