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Type 2

New Combination Drug: Trijardy XR Approved by FDA

By Eliza Skoler and Kelly Close

A new pill combines Jardiance, Tradjenta, and metformin to help people with type 2 diabetes manage blood glucose levels more easily, and in many different ways

A new, triple-impact drug has been approved by the FDA to help lower blood sugar in people with type 2 diabetes. Trijardy XR combines Jardiance (SGLT-2 inhibitor), Tradjenta (DPP-4 inhibitor), and extended-release metformin into a once-daily pill. This is the second triple combination pill to be approved by the FDA; the first was Qternmet (combining SGLT-2 inhibitor Farxiga, DPP-4 inhibitor Onglyza, and metformin), which was approved in May 2019. We love this new opportunity for people with diabetes to have two innovative drugs plus the traditional metformin in one easy to take pill. In the US, people have the added burden of co-pays for each therapy – we love that Trijardy XR requires only one prescription as well as one co-pay.

Dr. Ralph DeFronzo (who was responsible for some of the development of the SGLT-2 inhibitor “class” of drugs) is quoted in Lilly’s press release about Trijardy XR. He says that many people with type 2 diabetes need more than one medication to help them manage their blood glucose levels – and, we’d add, to assist in providing heart health benefits. Giving people a way to take several medications in one pill makes a treatment less burdensome for many. As Dr. DeFronzo says, “… having three different diabetes medications in a single tablet is an important advance in diabetes treatment."

What we know about these medications:

  • Jardiance has been shown to protect the heart in people with or without heart disease. That great news for helping people with type 2 diabetes stay as healthy as possible for as long as possible.

  • Excitingly, a study earlier this year, called VERIFY, showed that the combination of DPP-4 inhibitors and metformin delayed the rise in A1C to above 7% by 26 months, compared to metformin alone (62 months, versus 36 months) for people with type 2 diabetes. Treatment with the combination drug also delayed the need for insulin therapy.

  • According to experts, adding SGLT-2 inhibitors to these early combo therapies is likely to increase effectiveness – not only in terms of lowering blood sugar, but also for long-term heart and kidney health.

  • Jardiance and Tradjenta are both known to help patients avoid low blood glucose (hypoglycemia), compared to sulfonylureas (drugs like glimepiride, glipizide, gliclazide) and insulin.

  • Jardiance is associated with weight loss for many people who take it.

If you are experiencing any hypoglcyemia with your current treatment, if you’d like to improve your A1C or weight management, or if your current oral medication costs are too high, consider starting a conversation with your healthcare team. Here are some ideas for starting a conversation about your therapy. Let us know your thoughts!

  • “Do you have any opinions about combination therapy? What do you see as advantages and disadvantages?”

  • “Some of the medicine I take seems to be associated with hypoglcyemia and/or weight gain. Is that possible to avoid?”

  • “I noticed there is a new drug that combines three therapies – metformin, an SGLT-2 inhibitor, and a DPP-4 inhibitor. Together, these prompt weight loss – is this something I should consider taking?”

No information is yet available about when people will be able to get Trijardy XR, nor has Lilly announced details on patient assistance programs or cost-savings programs for the medication. We feel certain there will be programs that reduce costs – Lilly has recently increased insulin affordability programs.