Insights from VERIFY: Early Combination Therapy Provides Better Glycaemic Durability Than a Stepwise Approach in Newly D
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COMMENTARY
Insights from VERIFY: Early Combination Therapy Provides Better Glycaemic Durability Than a Stepwise Approach in Newly Diagnosed Type 2 Diabetes David Matthews
. Stefano Del Prato . Viswanathan Mohan .
Chantal Mathieu . Sergio Vencio . Juliana C. N. Chan . Michael Stumvoll . Pa¨ivi Maria Palda´nius
Received: June 11, 2020 / Accepted: September 10, 2020 Ó The Author(s) 2020
ABSTRACT The treatment aims for type 2 diabetes are to prevent complications and premature mortality, and improve quality of life. Glycaemic control is central to these aims; clinical guidelines have sought to achieve this with a stepwise approach starting with lifestyle measures and metformin, adding further medications once glycated haemoglobin (HbA1c) levels rise above a predefined threshold. However, treatment Digital Features To view digital features for this article go to https://doi.org/10.6084/m9.figshare.12789932. D. Matthews (&) Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK e-mail: [email protected]
intensification can be delayed when HbA1c levels increase, and HbA1c levels become inadequately controlled in many patients. Clinical inertia can result in sustained elevated levels of HbA1c; when combined with a late diagnosis, this negatively impacts patients’ prognosis. Early combination therapy using medications with complementary modes of action could achieve optimal glycaemic targets and alter the course of the disease more than metformin alone. The multinational VERIFY study (clinicaltrials.gov NCT01528254) provided evidence accrued over 5 years, demonstrating the potential of early combination therapy: time to loss of S. Vencio ICF Instituto de Cieˆncias Farmaceˆuticas de Estudos e Pesquisas Ltda, Aparecida de Goiaˆnia, GO, Brazil
D. Matthews Harris Manchester College, Oxford, UK
S. Vencio Aparecida Municipal Hospital, HMAP, Aparecida de Goiaˆnia, GO, Brazil
S. Del Prato Section of Metabolic Diseases and Diabetes, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
J. C. N. Chan Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
V. Mohan Madras Diabetes Research Foundation, Dr. Mohan’s Diabetes Specialties Centre, ICMR Centre for Advanced Research on Diabetes, Gopalapuram, Chennai 600086, India
J. C. N. Chan Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
C. Mathieu Department of Endocrinology, UZ Gasthuisberg, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
J. C. N. Chan Li Ka Shing Institute of Health Science, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
Diabetes Ther
glycaemic control was nearly doubled, and more than twice the number of patients experienced extended glycaemic control, with a vildagliptin–metformin combination therapy versus metformin alone. The study also showed a delay in secondary treatment failure in patients receiving the combination. Early combination therapy
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