The Scottish Medicine Consortium (SMC) approved restricted use of the drug in adult patients with type-2 diabetes as an add-on combination therapy with metformin, when metformin plus exercise does not achieve adequate glycaemic control.

The dipeptidyl peptidase-4 inhibitor is restricted to use when the addition of sulphonylureas is not appropriate, and represents an alternative to other agents such as thiazolidinediones, said the SMC.

Efficacy, as assessed by lowering of HbA1c, is comparable to other dipeptidyl peptidase-4 inhibitors and the drug appeared to have minimal effect on body weight, it added.

Saxagliptin is also licensed for use in combination with sulphonylureas or thiazolidinedione drugs for the treatment of type-2 diabetes. The manufacturer's submission related only to the use of saxagliptin in combination with metformin. 

However, the SMC said it cannot recommend the use of saxagliptin in combination with sulphonylureas or thiazolidinediones.

Manufacturer Bristol-Myers Squibb estimated that 4,576 patients would be eligible for add-on treatment with a thiazolidinedione or DPP-IV inhibitor.