The National Institute for Health and Care Excellence (NICE) recommends ertugliflozin (Steglatro) with or without metformin for treating adults with type 2 diabetes (T2D).
Ertugliflozin is recommended as monotherapy for the treatment of T2D in adults with a contraindication or intolerance for metformin and when diet and exercise alone are unable to provide adequate glycaemic control if the following conditions are fulfilled:
- A dipeptidyl peptidase 4 inhibitor would be prescribed otherwise and
- A sulfonylurea or pioglitazone is not suitable.
Ertugliflozin is recommended in combination with metformin for the treatment of T2D if the following conditions are fulfilled:
- Contraindication or intolerance for sulphonylurea or
- Significant risk for hypoglycaemia or its repercussions.
Recommended starting dose for ertugliflozin is 5 mg once daily, which can be increased to 15 mg once daily if additional glycaemic control is required and the initial dose is tolerated. Indirect comparison of ertugliflozin with other sodium-glucose cotransporter 2 (SGLT-2) inhibitors including canagliflozin, dapagliflozin, and empagliflozin showed comparable overall health benefits. If a prescription choice has to be made between ertugliflozin, canagliflozin, dapagliflozin, and empagliflozin, the least expensive option should be selected.
The recommendations should not affect patients whose treatment with the drug started before publication of the guidance.