The National Institute for Health and Care Excellence (NICE) has issued guidance on the clinical and cost-effectiveness of empagliflozin in combination therapy for treatment of type 2 diabetes.

The guideline, released in March, is for advanced-practice nurses, nurses, physician assistants, and physicians, according to a summary by the National Guideline Clearinghouse (NGC).

The summary lists recommendations by NICE for treatment of type 2 diabetes as follows:

• Empagliflozin in a dual-therapy regimen in combination with metformin, only if a sulfonylurea is contraindicated or not tolerated, or if the person is at significant risk of hypoglycemia or its consequences.

• Empagliflozin in a triple-therapy regimen, in combination with metformin and a sulfonylurea or metformin and a thiazolidinedione.• Empagliflozin in combination with insulin with or without other antidiabetic drugs.

According to the summary, the most commonly reported adverse reactions for empagliflozin are hypoglycemia in combination with insulin or a sulfonylurea, vulvovaginal candidiasis, urinary tract infection, and polyuria or pollakiuria.

As for the cost-effectiveness, an appraisal committee independent of NICE “concluded that the very small differences in costs and quality-adjusted life years between empagliflozin (10 mg and 25 mg) and its key comparators showed that empagliflozin was a cost-effective use of National Health Service resources as dual therapy in combination with metformin, triple therapy in combination with metformin and either a sulfonylurea or a thiazolidinedione, and as an add-on treatment to insulin.”