UK patients with type II diabetes have gained another treatment option for improving blood glucose levels with the launch of AstraZeneca's Xigduo this week.

Xigduo combines diabetes therapies Forxiga (dapagliflozin) and metformin in a twice-daily tablet, indicated for use in patients inadequately controlled on their current metformin-based treatment regimen, or who are currently being treated with the combination of dapagliflozin and metformin as separate tablets.

Its European nod in January marked the first regulatory approval for a fixed-dose combination of an SGLT2 inhibitor, which blocks the reabsorption of glucose by the kidney, with metformin, which suppresses glucose production by the liver and is the first line drug of choice for type II diabetes around the world.

Dapagliflozin and metformin are often prescribed together as they have complementary mechanisms of action, and so their availability in a single tablet "provides us with another treatment option to offer our type 2 diabetes patients, which is welcome as the need to individualise diabetes care is becoming increasingly important," noted Prof John Wilding, Head of the Department of Obesity and Endocrinology at the University of Liverpool. 

The drug will be immediately available for use on the NHS in England and Wales, given that cost regulators have decided that an appraisal is not necessary since guidance on dapagliflozin already covers patients who would be eligible for Xigduo. 

AstraZeneca said it will be submitting its combo for an abbreviated appraisal by the Scottish Medicines Consortium.

An estimated 2.88 million people in the UK are living with type 2 diabetes (with a further 765,000 undiagnosed) and many remain poorly controlled, highlighting both the scale of problem and urgent need for a wide arsenal of therapies.