Director-Professor and Head of Medicine, MLN Medical College, Prayagraj.
Senior Medical Advisor, Medical Department of Alkem Laboratory, Mumbai, Maharashtra.
J Assoc Physicians India. 2021 Feb;69(2):25-29.
Achieving adequate glycemic control in type 2 diabetes mellitus (T2DM) remains a difficult but achievable goal. Oral agents (OADs) are important option for management of T2DM. Most T2DM patients require more than one medication for adequate glycemic control. Metformin based combination therapy is recommended when monotherapy is insufficient. Evogliptin is a recently developed dipeptidyl peptidase-4 (DPP-4) inhibitor, which can to be combined with metformin for treating T2DM. Combination therapy of Evogliptin and Metformin lowers blood glucose via augmentation of insulin secretion, suppression of glucagon secretion, and insulin sensitization. Co-administration of Evogliptin and Metformin showed no clinically relevant pharmacokinetic differences compared to the administration of each drug alone. Combination therapy of Evogliptin and Metformin also provides significantly better glycemic control compared to the respective monotherapies. Efficacy and safety of Evogliptin and Metformin had been demonstrated in several multicentre randomized clinical trials conducted in various countries like South Korea, Russia and India. Consequently, fixed dose combination (FDC) of Evogliptin and Metformin is approved in South Korea and India. Complexity of the treatment regimen and polypharmacy are well-known factors of poor medication adherence and FDCs have the potential to improve adherence by reducing the pill burden. Adoption of this combination therapy in clinical practice for management of T2DMs will provide a greater degree of HbA1c reduction than that observed with the use of either drug as monotherapy, and is unlikely to cause significant hypoglycemia. Combination therapy of Evogliptin and Metformin is a promising strategy in the treatment of T2DM.
在 2 型糖尿病（T2DM）中实现充分的血糖控制仍然是一个困难但可实现的目标。口服药物（OADs）是 T2DM 管理的重要选择。大多数 T2DM 患者需要一种以上的药物来达到充分的血糖控制。当单药治疗不足时，推荐使用基于二甲双胍的联合治疗。依格列净是一种新开发的二肽基肽酶-4（DPP-4）抑制剂，可与二甲双胍联合用于治疗 T2DM。依格列净和二甲双胍的联合治疗通过增加胰岛素分泌、抑制胰高血糖素分泌和增强胰岛素敏感性来降低血糖。依格列净和二甲双胍联合用药与单独用药相比，没有临床相关的药代动力学差异。与各自的单药治疗相比，依格列净和二甲双胍的联合治疗也能提供更好的血糖控制。依格列净和二甲双胍在韩国、俄罗斯和印度等多个国家进行的多项多中心随机临床试验中已证明其疗效和安全性。因此，依格列净和二甲双胍的固定剂量复方制剂（FDC）已在韩国和印度获得批准。治疗方案的复杂性和多药治疗是药物依从性差的已知因素，而 FDC 有可能通过减少用药负担来提高依从性。在 T2DM 的临床实践中采用这种联合治疗方案，将提供比单独使用任何一种药物作为单药治疗更大程度的糖化血红蛋白降低，并且不太可能导致严重的低血糖。依格列净和二甲双胍的联合治疗是治疗 T2DM 的一种很有前途的策略。
