saxagliptin + metformin (Komboglyze)

Following an abbreviated submission:

saxagliptan + metformin (Komboglyze) is accepted for restricted use within NHS Scotland.

Indication under review: adjunct to diet and exercise to improve glycaemic control in adult patients aged 18 years and older with type 2 diabetes mellitus inadequately controlled on their maximally tolerated dose of metformin alone or those already being treated with the combination of saxagliptin and metformin as separate tablets.

SMC restriction: use in patients for whom a combination of saxagliptin and metformin is an appropriate choice of therapy and only when the addition of sulphonylureas to metformin monotherapy is not appropriate.

Saxagliptin represents an alternative to other agents such as thiazolidinediones. Efficacy, as assessed by measurement of HbA1c, is comparable to another dipeptidyl peptidase-4 inhibitor. It appears to have minimal effect on body weight.

Saxagliptin/metformin is also licensed for use in combination with insulin for the treatment of type 2 diabetes. The manufacturer’s submission related only to the use of saxagliptin and metformin in combination therefore SMC cannot recommend the use of saxagliptin/metformin in combination with insulin.