The power of two: an update on fixed-dose combinations for type 2 diabetes

ABSTRACT

Introduction: Patients with type 2 diabetes mellitus (T2DM) are unlikely to maintain glycemic control with monotherapy, and will eventually require therapy with multiple antihyperglycemic agents (AHAs). Combination therapy regimens with multiple AHAs may be complex and negatively impact patient adherence. Fixed-dose combinations (FDCs) are used successfully for management of numerous chronic diseases.

Areas covered: This article includes a brief overview of the add-on approach of current treatment guidelines for T2DM and reviews the evidence supporting the utility of oral FDCs in the treatment of T2DM, including recently developed oral FDCs (2010–2016). Benefits regarding safety and tolerability, adherence and cost are also discussed. Finally, the barriers limiting the use of FDCs and how these barriers may be overcome are addressed.

Expert commentary: Therapeutic strategies including FDCs need to be implemented on a larger scale. FDCs have the potential to simplify treatment regimens, improve adherence and provide long-term glycemic control.

KEYWORDS:

• Adherence
• combination therapy
• fixed-dose combination
• type 2 diabetes mellitus

Declaration of interest

SB Harris has received grants/research support from Abbott, AstraZeneca, Boehringer Ingelheim/Lilly, Novo Nordisk, Janssen and Sanofi. He has received honoraria and consulting fees from Abbott, AstraZeneca, Boehringer Ingelheim/Lilly, Janssen, Novo Nordisk, and Sanofi and honoraria from Medtronic and Merck. The author has no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. The author meets criteria for authorship as recommended by the International Committee of Medical Journal Editors. The author received no direct compensation related to the development of the manuscript. Writing assistance was utilised in the preparation of this manuscript, it was funded by Boehringer Ingelheim Pharmaceuticals, Inc and carried out by Dhinakaran Sambandan, PhD, and editorial assistance was provided by Marissa Buttaro, MPH, both of Envision Scientific Solutions. Boehringer Ingelheim Pharmaceuticals, Inc. was given the opportunity to review the manuscript for medical and scientific accuracy as well as intellectual property considerations.

Additional information

Funding

This paper was not funded.