Determination of the Effect of a Teneligliptin-Canagliflozin Combination Drug Using Free Style Libre Pro
Authors: TOSAKI TAKAHIRO , KAMIYA HIDEKI , SATO SHIORI , KUDARA AYAE , INAGAKI AKEMI , KONDO MASAKI , TSUNEKAWA SHIN , KATO YOSHIRO , NAKAMURA JIRO 
Published: June 2018

A combination drug comprising teneligliptin (Ten) and canagliflozin (Can) became commercially available in Japan in September 2017. No studies reported the effect of this combination drug on variations in blood glucose levels through continuous blood glucose monitoring with the Free Style Libre Pro (Libre Pro). This study prospectively examined the effects in patients treated with either Ten or Can. The subjects were 15 outpatients with diabetes with HbA1c levels ranging from 6.5% to 15% who had been treated with Ten 20 mg (10 patients) or Can 100 mg (5 patients). Doses of antidiabetes drugs other than Ten and Can were maintained throughout the study. The subjects used Libre Pro for 2 weeks. During the first week, Ten or Can was administered. During the second week, the teneligliptin-canagliflozin combination drug (TC) was administered. After completing Libre Pro monitoring, TC was administered continuously for 3 weeks, while patients were followed on an outpatient basis (UMIN000029015). Glycoalbumin level of the Ten group and Can group decreased significantly after switching to TC (p = 0.002, p = 0.035). Over 7 days, the Libre Pro-measured mean blood glucose level of the both group ameliorated significantly after switching to TC (p &lt; 0.001, p = 0.006). Regarding blood glucose variation, the median standard deviation (SD) decreased significantly from 39.2 to 30.5 of the Ten group after switching to TC (p = 0.002), and from 32.9 to 24.4 of the Can group (p = 0.024). In the Ten group, The mean amplitude of glycemic excursions (MAGE) at day 7 improved significantly from 75.0 mg/dL to 47.5 mg/dL after switching to TC (p = 0.013); in the Can group, from 88.5 mg/dL to 44.5 mg/dL (p = 0.043). There were no significant changes in fasting blood glucagon levels in either group. These results indicate that patients who switched from Ten to TC experienced significant improvements in blood glucose control, as assessed by Libre Pro.

Disclosure
T. Tosaki: Other Relationship; Self; Eli Lilly and Company, Takeda Development Center Asia, Pte. Ltd., MSD K.K., Mitsubishi Tanabe Pharma Corporation. H. Kamiya: Other Relationship; Self; MSD K.K., Ono Pharmaceutical Co., Ltd., Sanofi K.K., AstraZeneca, Astellas Pharma KK, Eli Lilly and Company, Novartis Pharma K.K., Dainippon Sumitomo Pharma Co., Ltd, Boehringer Ingelheim Pharmaceuticals, Inc., Takeda Pharmaceutical Co., Ltd, Ono Pharmaceutical Co., Ltd.. S. Sato: None. A. Kudara: None. A. Inagaki: None. M. Kondo: None. S. Tsunekawa: None. Y. Kato: Speaker's Bureau; Self; Merck Sharp & Dohme Corp., Sanofi, Takeda Pharmaceutical Company, Eli Lilly Japan. J. Nakamura: Other Relationship; Self; Astellas Pharma US, Inc., AstraZeneca, Ono Pharmaceutical Co., Ltd., MSD K.K., Kyowa Hakko Kirin Co., Ltd., Kowa Pharmaceuticals America, Inc., Sanofi K.K., Taisho Pharmaceutical Co., Ltd., Takeda Development Center Asia, Pte. Ltd., Mitsubishi Tanabe Pharma Corporation, Eli Lilly and Company, Novartis Pharma K.K., Pfizer Inc..