metformin + sitagliptin + empagliflozin + pioglitazone

Metformin + sitagliptin + empagliflozin + pioglitazone is an investigational four-drug combination therapy, also known as POLYCHEM, developed by the Azienda Ospedaliero-Universitaria di Parma for the treatment of newly diagnosed type 2 diabetes mellitus. This intensive regimen is being evaluated in the Phase 3 MIRACLE trial to induce diabetes remission by simultaneously targeting multiple physiological defects. The combination includes metformin (an AMPK activator that reduces hepatic glucose production), sitagliptin (a DPP-4 inhibitor that increases incretin levels), empagliflozin (an SGLT2 inhibitor that promotes renal glucose excretion), and pioglitazone (a PPAR-gamma agonist that improves insulin sensitivity). The 16-week treatment protocol aims to reverse glucose toxicity and restore beta-cell function, potentially leading to long-term euglycemia without the need for ongoing medication.

Other names

MIRACLE trial regimenmetformin + pioglitazone + sitagliptin + empagliflozin