A NOVEL ANTIOXIDANT-DAPAGLIFLOZIN COMBINATION: COMBATING DIABETIC KIDNEY DISEASE AT THE CELLULAR LEVEL

At present, the significant cause of chronic kidney disease (CKD) is said to be Diabetic Kidney Disease (DKD). This condition considerably impacts cost of healthcare, mortality and morbidity worldwide. Current treatment options for DKD basically focusses on Blood Pressure (BP) regulation, glycemic control along with suppression of Renin-Angiotensin-Aldosterone System (RAAS). The advancing nature of pathophysiology of DKD demands additional treatment options to reduce the ongoing chronic inflammation and oxidative stress as they are the key operators of renal dysfunction. In the current review, we put forward a novel, rationally designed antioxidant-Dapagliflozin combination as a single tablet formulation incorporating N-Acetyl Cysteine (NAC), Taurine, Alpha-Lipoic Acid (ALA) and Coenzyme Q10 (CoQ10) with Dapagliflozin to boost renoprotection in DKD. In this review, we have explored the pathophysiological rationale underlying this novel drug combination, its mechanism, synergistic potential, efficacy in preventing development of DKD at the cellular level and challenges in drug formulation. This is the first article to propose this novel combination by incorporating SGLT-2 inhibitor with antioxidants based on scientific rationale to target multidimensional cellular mechanism in DKD progression. By addressing challenges in the formulation through innovative pharmaceutical techniques and rigorous clinical approval, this formulation might have a great success in clinical practice as it has an immense potential to improve patient outcome by reducing the stress of polypharmacy while simultaneously preventing the onset and progression of DKD in diabetic patients.