What is the purpose of XIGDUO (dapagliflozin and metformin)?

From the Guidelines

Xigduo's primary purpose is to lower blood sugar levels in adults with type 2 diabetes by combining dapagliflozin and metformin, which not only improves glycemic control but also reduces the risk of cardiovascular and kidney disease, as evidenced by the DAPA-CKD study 1. The medication works by utilizing dapagliflozin to help the kidneys remove excess sugar from the bloodstream through urine, and metformin to reduce glucose production in the liver and improve the body's response to insulin. This dual-action approach is crucial for managing type 2 diabetes, especially considering the findings from the DAPA-CKD study, which showed that dapagliflozin significantly reduced the risk of kidney disease progression and cardiovascular events in patients with chronic kidney disease 1. Key benefits of Xigduo include:

• Lowering blood sugar levels
• Reducing the risk of cardiovascular events, such as heart failure hospitalizations and cardiovascular death
• Slowing the progression of kidney disease, as demonstrated by the reduction in sustained decline in eGFR, ESRD, or death from renal causes in the DAPA-CKD study 1 It is essential for patients to maintain regular blood sugar monitoring while using Xigduo and continue following recommendations for diet and exercise as part of their overall diabetes management plan. The dosage and administration of Xigduo should be individualized, taking into account the patient's renal function and other health status, with the goal of maximizing the benefits of the medication while minimizing potential side effects.

From the FDA Drug Label

• DAPAGLIFLOZIN TABLETS are a prescription medicine used: ∘ to reduce the risk of further worsening of your kidney disease, end-stage kidney disease (ESKD), death due to cardiovascular disease, and hospitalization for heart failure in adults with chronic kidney disease ∘ to reduce the risk of cardiovascular death, hospitalization for heart failure and urgent heart failure visit in adults with heart failure, when the heart cannot pump enough blood to the rest of your body ∘ to reduce the risk of hospitalization for heart failure in adults with type 2 diabetes who also have known cardiovascular disease or multiple cardiovascular risk factors ∘ along with diet and exercise to improve blood sugar (glucose) control in adults and children who are 10 years of age and older with type 2 diabetes

The purpose of XIGDUO, which contains dapagliflozin, is to:

• Reduce the risk of worsening kidney disease and cardiovascular events in adults with chronic kidney disease
• Reduce the risk of cardiovascular death and hospitalization for heart failure in adults with heart failure
• Reduce the risk of hospitalization for heart failure in adults with type 2 diabetes and cardiovascular disease or risk factors
• Improve blood sugar control in adults and children 10 years and older with type 2 diabetes, in combination with diet and exercise 2

From the Research

XIGDUO Purpose

• XIGDUO is a fixed-dose combination of dapagliflozin and metformin, used to treat type 2 diabetes 3.
• The combination of these two drugs affects different pathophysiological mechanisms of type 2 diabetes, including insulin resistance and increased glucose reabsorption in the kidney 3.
• Dapagliflozin is a sodium-glucose cotransporter-2 inhibitor that improves glycemic control by increasing the renal excretion of excess glucose 4, 5.
• Metformin is a first-line pharmacotherapy for the treatment of type 2 diabetes, and the combination with dapagliflozin provides improved glycemic control and reduced body weight and blood pressure 3, 5.

Benefits of XIGDUO

• Improved patient adherence and utilization of the full therapeutic potential of selected drugs 3.
• Effective glycemic control, reduced body weight, and low risk of hypoglycemia 4, 5, 6.
• Reduced rate of cardiovascular death or hospitalization for heart failure, and possibly reduced progression of renal disease 4.
• Generally well-tolerated, with a low risk of hypoglycemia, although genital infections and diabetic ketoacidosis are more common with dapagliflozin than placebo 4, 6.

Clinical Evidence

• Clinical trials have shown that dapagliflozin as monotherapy and combination therapy with other antihyperglycemic agents provides effective glycemic control and reduced body weight and blood pressure 4, 5.
• A study comparing dapagliflozin with glipizide as add-on therapy in patients with type 2 diabetes inadequately controlled with metformin found that dapagliflozin produced significant weight loss and reduced hypoglycemia 6.
• A model-based approach to investigating the relationship between glucose-insulin dynamics and dapagliflozin treatment effect in patients with type 2 diabetes found that dapagliflozin-mediated glycemic control is anticorrelated to steady-state insulin concentration and insulin sensitivity 7.