The National Institute for Health and Care Excellence (NICE) recommends ertugliflozin (Steglatro) as part of triple therapy for treating adults with type 2 diabetes (T2D).
Ertugliflozin with metformin and a dipeptidyl peptidase-4 (DPP-4) inhibitor is recommended for the treatment of T2D in adults when diet and exercise alone are unable to provide adequate glycaemic control if the following conditions are fulfilled:
- a dual therapy with metformin and a DPP-4 inhibitor are unable to control the condition and
- a sulphonylurea or pioglitazone is not suitable.
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. In combination therapy, an individualised daily dose of 5 or 15 mg is recommended. Ertugliflozin belongs to the class sodium-glucose cotransporter 2 (SGLT-2) inhibitors, which also include canagliflozin, dapagliflozin and empagliflozin. Evidence shows that ertugliflozin has comparable health benefits to other SGLT-2 inhibitors as part of triple therapy with metformin and a DPP-4 inhibitor, with a lower acquisition cost.
The recommendations should not affect patients whose treatment with the drug started before the publication of the guidance.