The Scottish Medicines Consortium (SMC) has accepted saxagliptin (Onglyza) for restricted use within NHS Scotland in adult patients with type 2 diabetes mellitus as add-on therapy with metformin, when metformin alone, with diet and exercise, does not provide adequate glycaemic control. It is restricted to use only when the addition of sulfonylureas is not appropriate and is an alternative to other agents such as thiazolidinediones.
The SMC advises that the efficacy of saxagliptin, as assessed by measurement of HbA1c, is comparable to that of another dipeptidyl peptidase 4 inhibitor and that the drug appears to have minimal effect on body weight.
This SMC assessment related only to the use of saxagliptin in combination with metformin; therefore, the SMC cannot recommend the use of saxagliptin in combination with sulfonylureas or thiazolidinediones.
New guidance on the treatment of diabetes in Scotland, recently issued by the Scottish Intercollegiate Guidelines Network (SIGN), includes recommendations on the use of dipeptidyl peptidase 4 inhibitors.
Further information: SMC
