Evergreen Talk Series: Clinical applicability of Linagliptin in T2DM across CKD spectrum and Dapagliflozin up to CKD stage 4

Bringing viewpoints from the different specialities of Diabetology, Cardiology and Nephrology they share the clinical applicability of Linagliptin in T2DM across CKD spectrum and Dapagliflozin up to CKD stage 4

Dr Brij Mohan Makkar: Linagliptin and Dapagliflozin are considered safe for renal function, with Dapagliflozin recommended up to Stage 4 CKD. The combination of these two drugs offers effective renal protection. While these molecules demonstrate safety in individuals with moderate or possibly advanced CKD, limited data is available regarding the use of gliflozins in individuals with stage 4+ CKD.

Dr Sameer I Dani: Linagliptin has been shown on an experimental basis to reduce Myocardial fibrosis. It has direct cardiac benefits and significant evidence on human cardiovascular safety. Linagliptin also exhibits renal safety and is recommended across all stages of CKD. Dapagliflozin is effective in preventing and improving heart failure, even in individuals with low eGFR. When combined in CKD patients, Dapagliflozin and Linagliptin contribute to a reduction or improvement in cardiovascular outcomes, highlighting the advantage of combining these two drugs in the management of CKD.

Dr Tukaram Jamale: Linagliptin & Dapagliflozin are supported by evidence-based recommendations in T2DM & CKD. The availability of SGLT2 inhibitors has revolutionized the management of diabetic nephropathy. As a nephrologist, I observe that many patients are already on DPP4 inhibitors when they come into the clinic. When kidney disease sets in, either in the form of proteinuria or decreased GFR, there is a recommendation to initiate them on SGLT2 inhibitor. So, adding Linagliptin to Dapagliflozin can very well serve this particular purpose when considering putting patients on SGLT2 inhibitors.