The Use of Vildagliptin-Dapagliflozin Fixed Dose Combination in Different Patient Profiles in Indian Settings: An Opinion-Based Consensus

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Objective: To evaluate the opinions of Indian clinical experts and aid in clinical choices for the optimal use of vildagliptin-dapagliflozin fixed-dose combination (FDC) for treating type 2 diabetes (T2D) in Indian patients.

Methods: The virtual round table meetings (RTMs) were conducted with healthcare professionals (HCPs) across India. A questionnaire that highlighted the role of vildagliptin-dapagliflozin FDC in treating T2D and determining the correct patient profile was created. The experts held the questionnaire discussion, and their comments were documented. The collected data were evaluated and categorized into four grades: Level A, very strong (≥80% responses); Level B, strong (≥50-79% responses); Level C, moderate (25-49% responses); Level D, neutral/no consensus (<25% responses).

Results: More than 200 HCPs participated in 15 RTMs held between July 15 and October 22, 2022. With a consensus level A (Very strong), HCPs believed that vildagliptin-dapagliflozin FDC is an attractive option and suitable for a wide range of Indian T2D patient profiles, including those with atherosclerotic cardiovascular disease (ASCVD), those with a history of heart failure, older and obese individuals. The experts regarded vildagliptin-dapagliflozin FDC as the first-line treatment for T2D patients who were obese and hypertensive, with a consensus level of C (Moderate). Vildagliptin-dapagliflozin FDC was recommended as second-line treatment for obese and hypertensive T2D patients who are uncontrolled on metformin by experts with consensus level B (Strong). The clinical experts at consensus level B (Strong) agreed that T2D patients taking two oral antidiabetic drugs (OADs) and uncontrolled if HbA1c > 8% might be suitable candidates for initiating vildagliptin-dapagliflozin FDCs.

Conclusion: Based on the present expert opinion-based consensus, most clinical experts believe that vildagliptin – dapagliflozin FDC is an appealing treatment option for a broad range of Indian T2D patients. Nevertheless, more multicentric studies are needed to support these recommendations.