Mario Luca Morieri1, Agostino Consoli2, Giorgio Sesti3, Francesco Purrello4, Angelo Avogaro1, Gian Paolo Fadini1. 1. Department of Medicine, University of Padova, Padova, Italy. 2. DMSI and CeSI-Met, University of Chieti, Chieti, Italy. 3. Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy. 4. Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
Abstract
BACKGROUND: Treatment of type 2 diabetes (T2D) should aim at preventing or delaying complications through the control of glycaemia and cardiovascular risk factors. We herein compared the SGLT-2 inhibitor dapagliflozin vs DPP-4 inhibitors (DPP-4i) on a composite endpoint of glycaemic and extraglycaemic effectiveness. METHODS: This was a multicentre, retrospective real-world study conducted at 56 outpatient clinics in Italy. We collected data on patients newly started on dapagliflozin or DPP-4i in 2015-2017. The primary endpoint was the proportion of patients attaining a simultaneous reduction of HbA1c ≥0.5%, body weight ≥2 kg, systolic blood pressure (SBP) ≥2 mmHg. Confounding by indication was addressed by propensity score matching (PSM) or multivariable adjustment (MVA). RESULTS: Patients initiating dapagliflozin (n = 2091) or DPP-4i (n = 2144) differed for most clinical characteristics. After PSM, two well-balanced groups of 1149 patients each were compared. The primary endpoint was reached in a greater proportion of patients who received dapagliflozin (17.6%) compared to DPP-4i (11.7%), with a relative risk of 1.50 (1.21-1.86; P < .001). Similar results were obtained in the as-treated and intention-to-treat datasets or using MVA in place of PSM. The beneficial effect of dapagliflozin was mainly due to its greater effectiveness on body weight and, to a lesser extent, on SBP. The change in HbA1c did not differ between groups. CONCLUSIONS: T2D patients initiating the SGLT2i dapagliflozin had a greater probability of attaining a composite endpoint of clinically relevant reductions in HbA1c, body weight and SBP, compared to similar patients initiating a DPP-4i in the same period and healthcare setting.
BACKGROUND: Treatment of type 2 diabetes (T2D) should aim at preventing or delaying complications through the control of glycaemia and cardiovascular risk factors. We herein compared the SGLT-2 inhibitor dapagliflozin vs DPP-4 inhibitors (DPP-4i) on a composite endpoint of glycaemic and extraglycaemic effectiveness. METHODS: This was a multicentre, retrospective real-world study conducted at 56 outpatient clinics in Italy. We collected data on patients newly started on dapagliflozin or DPP-4i in 2015-2017. The primary endpoint was the proportion of patients attaining a simultaneous reduction of HbA1c ≥0.5%, body weight ≥2 kg, systolic blood pressure (SBP) ≥2 mmHg. Confounding by indication was addressed by propensity score matching (PSM) or multivariable adjustment (MVA). RESULTS: Patients initiating dapagliflozin (n = 2091) or DPP-4i (n = 2144) differed for most clinical characteristics. After PSM, two well-balanced groups of 1149 patients each were compared. The primary endpoint was reached in a greater proportion of patients who received dapagliflozin (17.6%) compared to DPP-4i (11.7%), with a relative risk of 1.50 (1.21-1.86; P < .001). Similar results were obtained in the as-treated and intention-to-treat datasets or using MVA in place of PSM. The beneficial effect of dapagliflozin was mainly due to its greater effectiveness on body weight and, to a lesser extent, on SBP. The change in HbA1c did not differ between groups. CONCLUSIONS: T2D patients initiating the SGLT2i dapagliflozin had a greater probability of attaining a composite endpoint of clinically relevant reductions in HbA1c, body weight and SBP, compared to similar patients initiating a DPP-4i in the same period and healthcare setting.
Authors: José M González-Clemente; María García-Castillo; Juan J Gorgojo-Martínez; Alberto Jiménez; Ignacio Llorente; Eduardo Matute; Cristina Tejera; Aitziber Izarra; Albert Lecube Journal: Diabetes Ther Date: 2022-06-10 Impact factor: 3.595
Authors: Cristóbal Morales; Juan Francisco Merino-Torres; Paloma Moreno-Moreno; María Lainez; Iñigo Tejado; Alfredo Yoldi; Sonsoles Gutiérrez Medina; Alfonso Soto; Manuel A Botana; Virginia Bellido; Irene Caballero Journal: Drugs Context Date: 2022-02-17
Authors: John P H Wilding; Marc Evans; Kevin Fernando; Jose Luis Gorriz; Ana Cebrian; Jane Diggle; Debbie Hicks; June James; Philip Newland-Jones; Amar Ali; Stephen Bain; Andrea Da Porto; Dipesh Patel; Adie Viljoen; David C Wheeler; Stefano Del Prato Journal: Diabetes Ther Date: 2022-03-20 Impact factor: 3.595
Authors: Gian Paolo Fadini; Raffaella Buzzetti; Maria Rosa Fittipaldi; Ferruccio D'Incau; Andrea Da Porto; Angela Girelli; Lucia Simoni; Giusi Lastoria; Agostino Consoli Journal: Diabetes Ther Date: 2022-06-18 Impact factor: 3.595
Authors: Virginia Bellido; Julia Martínez; Fernando Calvo; Aida Villarroel; Edurne Lecumberri; Juan Moreno; Carlos Morillas; Silvia Rodrigo; Aitziber Izarra; Albert Lecube Journal: Diabetes Ther Date: 2022-03-25 Impact factor: 3.595