EFFICACY AND SAFETY OF EMPAGLIFLOZIN COMBINED WITH METFORMIN (JARDIANCE DUO) IN GLYCEMIC CONTROL OF PATIENTS WITH TYPE 2 DIABETES MELLITUS
DOI:
https://doi.org/10.56238/levv16n55-124Keywords:
Type 2 Diabetes Mellitus, Empagliflozin, Metformin, Combination Therapy, Integrative ReviewAbstract
Type 2 diabetes mellitus (T2DM) is a chronic metabolic disease characterized by insulin resistance and progressive β-cell dysfunction, resulting in persistent hyperglycemia. Metformin, the first-line drug for T2DM treatment, is often insufficient to maintain long-term glycemic control, requiring combination therapy with other antihyperglycemic agents. Among the new therapeutic options, empagliflozin, a selective sodium-glucose cotransporter 2 (SGLT2) inhibitor, stands out for its additional benefits on body weight, blood pressure, and cardiovascular and renal function. Therefore, this study aimed to analyze scientific evidence published over the last ten years regarding the efficacy and safety of the empagliflozin/metformin combination (Jardiance Duo) in glycemic control of patients with T2DM. This is an integrative literature review conducted in the PubMed, SciELO, ScienceDirect, and Scopus databases, including articles published between 2015 and 2025. A total of 11 studies met the eligibility criteria. The findings showed that the combined therapy promotes significant reductions in glycated hemoglobin (HbA1c), improved glycemic control, and additional metabolic benefits, with a favorable safety profile and low incidence of severe adverse events. In conclusion, the empagliflozin/metformin combination is effective, safe, and cost-effective, representing a promising therapeutic strategy for the management of type 2 diabetes mellitus and aligned with current national and international clinical guidelines.
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BRASIL. Resolução nº 510, de 7 de abril de 2016. Dispõe sobre as normas aplicáveis a pesquisas em Ciências Humanas e Sociais. Diário Oficial da União, Brasília, DF, 2016. Disponível em: https://conselho.saude.gov.br/resolucoes/2016/Reso510.pdf. Acesso em: 10 dez. 2025.
GOLDMAN, J. D. et al. Combination therapy with empagliflozin and metformin for type 2 diabetes: efficacy and safety. Diabetes Therapy, v. 9, n. 4, p. 1945–1961, 2018. DOI: 10.1007/s13300-018-0467-2.
HADJADJ, S. et al. Empagliflozin and metformin as initial combination therapy in patients with type 2 diabetes mellitus: a randomized, double-blind, placebo-controlled trial. Diabetes Care, v. 39, n. 12, p. 2036–2045, 2016. DOI: 10.2337/dc16-1318.
INTERNATIONAL DIABETES FEDERATION (IDF). IDF Diabetes Atlas. 10th ed. Brussels: IDF, 2023. Disponível em: https://diabetesatlas.org. Acesso em: 12 dez. 2025.
JI, L. et al. Efficacy and safety of empagliflozin in combination with insulin in Chinese patients with type 2 diabetes and insufficient glycaemic control: a phase III study. Diabetes, Obesity & Metabolism, v. 25, n. 1, p. 42–52, 2023. DOI: 10.1111/dom.14912.
JARDIANCE STUDY GROUP. Empagliflozin and clinical outcomes in patients with type 2 diabetes: cardiovascular and renal effects. New England Journal of Medicine, v. 383, n. 11, p. 993–1004, 2020. DOI: 10.1056/NEJMoa2024280.
KEDIA, R. et al. Spotlight on empagliflozin/metformin fixed-dose combination for the treatment of type 2 diabetes: a systematic review. Patient Preference and Adherence, v. 10, p. 1999–2006, 2016. DOI: 10.2147/PPA.S113524.
KHAN, M.; KHAN, S. Comparison of empagliflozin and vildagliptin for glycemic control and safety in type 2 diabetes patients on metformin. Frontiers in Endocrinology, v. 13, e871295, 2022. DOI: 10.3389/fendo.2022.871295.
MENDES, K. D. S.; SILVEIRA, R. C. C. P.; GALVÃO, C. M. Revisão integrativa: método de pesquisa para a incorporação de evidências na saúde e na enfermagem. Texto & Contexto – Enfermagem, Florianópolis, v. 17, n. 4, p. 758–764, 2008. DOI: 10.1590/S0104-07072008000400018.
MDPI. Metabolic and hepatic effects of empagliflozin/metformin combination in patients with type 2 diabetes and metabolic dysfunction-associated steatotic liver disease (MASLD). Journal of Clinical Medicine, v. 14, n. 3, p. 1221–1234, 2025. DOI: 10.3390/jcm14031221.
PARK, Y. H. et al. Two-year therapeutic efficacy and safety of initial triple combination of metformin, sitagliptin, and empagliflozin in drug-naïve type 2 diabetes mellitus patients. Diabetes & Metabolism Journal, v. 48, p. 253–264, 2024. DOI: 10.4093/dmj.2023.0145.
RAMOS, M.; CUMMINGS, M. Long-term cost-effectiveness analyses of empagliflozin combination therapy in type 2 diabetes patients in the UK. Diabetes Therapy, v. 11, p. 325–340, 2020. DOI: 10.1007/s13300-019-00761-9.
SOCIEDADE BRASILEIRA DE DIABETES (SBD). Diretrizes da Sociedade Brasileira de Diabetes 2023–2024. São Paulo: SBD, 2023. Disponível em: https://www.diabetes.org.br. Acesso em: 12 dez. 2025.
SOUZA, M. T.; SILVA, M. D.; CARVALHO, R. Revisão integrativa: o que é e como fazer. Einstein (São Paulo), v. 8, n. 1, p. 102–106, 2010. DOI: 10.1590/S1679-45082010RW1134.
WAZIR, N.; REHMAN, S. Efficacy and safety of empagliflozin as add-on therapy in patients of type 2 diabetes mellitus. Journal of Gandhara Medical and Dental Science, v. 9, n. 1, p. 45–52, 2022. Disponível em: https://jgmds.org. Acesso em: 8 dez. 2025.
ZHONG, S. et al. Empagliflozin as add-on to metformin improves glycemic control, body weight and blood pressure in type 2 diabetes mellitus: a randomized controlled trial. Diabetes, Obesity & Metabolism, v. 18, n. 4, p. 370–377, 2016. DOI: 10.1111/dom.12635.