Evergreen Talk Series: Linagliptin and Dapagliflozin combination for T2DM with Cardiovascular risk or established ASCVD

Presenting the Evergreen Talk Series featuring Dr. Brij Mohan
Makkar, a Senior Diabetologist and Obesity Specialist from Delhi, Dr. Sameer I.
Dani, an Interventional Cardiologist from Ahmedabad, and Dr. Tukaram Jamale, a
Nephrologist and Kidney Transplant Physician who serves as the Head of the
Department at KEM Hospital Mumbai. They provide their insights on the use of
Linagliptin, Dapagliflozin, and Metformin for diabetic patients.

Bringing viewpoints from the different specialities of
Diabetology, Cardiology and Nephrology they share the clinical benefits of the
Linagliptin and Dapagliflozin combination for T2DM with Cardiovascular risk or
established ASCVD.

Dr Brij Mohan Makkar: When Linagliptin and Dapagliflozin are combined, Linagliptin
demonstrates cardiovascular safety, hepatic safety, renal safety, no risk of
hypoglycemia, and no weight gain. It acts indirectly on insulin secretion and
suppresses glucagon. SGLT2 inhibitors are useful in reducing mortality in
people with established atherosclerotic cardiovascular disease, heart failure,
and advanced chronic kidney disease. Therefore, using this combination of
molecules in people with established atherosclerotic cardiovascular disease or
those at high risk is the recommended choice according to almost every
guideline now.

Dr Sameer I Dani: Linagliptin and Dapagliflozin both have established evidence or
a record of cardiovascular safety. Both have enough evidence for cardiorenal
safety. These medicines belong to two different classes of drugs and complement
each other. They have different mechanisms of action, different pathways of
metabolism, and that’s how they complement each other without causing drug
interactions. So, the chances of drug-drug interactions are very low. Both
agents have cardiovascular outcome benefits, making the combination use very
logical.

Dr Tukaram Jamale: One of the important reasons that patient discontinues or
decrease the dosages of the drug is cost and the pill burden. Patients at
elevated ASCVD risks stand to benefit the most from these drugs individually.
Therefore, a combination approach serves the purpose of making the treatment
available at a substantially lower cost and reduces the number of pills to be
consumed in a day.