Dapagliflozin versus saxagliptin as add-on therapy in patients with type 2 diabetes inadequately controlled with metformin

Abstract

Objective: This analysis compared the efficacy and safety of the sodium-glucose cotransporter-2 (SGLT2) inhibitor, dapagliflozin, and the dipeptidyl peptidase-4 (DPP4) inhibitor, saxagliptin, both added on to metformin. Materials and methods: This was a post-hoc analysis from a double-blind, randomized, 24-week clinical trial (NCT01606007) of patients with type 2 diabetes (T2D) inadequately controlled with metformin. We compared the dapagliflozin 10 mg (n = 179) and saxagliptin 5 mg (n = 176) treatment arms. Results: Dapagliflozin showed significantly greater mean reductions versus saxagliptin in HbA 1c (difference versus saxagliptin [95% CI]:-0.32% [-0.54,-0.10]; p < 0.005), fasting plasma glucose (-0.98 [-1.42,-0.54] mmol/L; p < 0.0001), body weight (-2.39 [-3.08,-1.71] kg; p < 0.0001) and systolic blood pressure (SBP) (-3.89 [-6.15,-1.63] mmHg; p < 0.001). More dapagliflozintreated than saxagliptin-treated patients achieved the composite endpoint of HbA 1c reduction ≥ 0.5%, weight loss ≥ 2 kg, SBP reduction ≥ 2 mmHg and no major/minor hypoglycemia (24% versus 7%). No major events of hypoglycemia were reported. More patients on dapagliflozin (6%) versus saxagliptin (0.6%) experienced genital infections. Conclusion: Dapagliflozin demonstrated greater glycemic efficacy than saxagliptin with additional benefits on weight and SBP, and the safety profile was consistent with previous studies.

Durability of glycaemic control with dapagliflozin, an SGLT2 inhibitor, compared with saxagliptin, a DPP4 inhibitor, in patients with inadequately controlled type 2 diabetes

“…The similar maintenance of FPG, SBP, and body weight from Weeks 20–102 in indirect (CoF) comparison of dapagliflozin and saxagliptin reflects the fact that most of the changes in these parameters occurred in the first 20 weeks from treatment initiation. A recent post hoc analysis of the present short‐term trial showed that dapagliflozin significantly reduced the FPG, SBP, and body weight as compared to saxagliptin over 24 weeks.…”

“…Although metformin is recommended as a first‐line oral antihyperglycaemic drug, sodium‐glucose cotransporter‐2 (SGLT2) inhibitors and dipeptidyl peptidase‐4 (DPP4) inhibitors offer additional glycaemic control and weight control, with minimal risk of hypoglycaemia . Dapagliflozin, an SGLT2 inhibitor, exhibits greater glycaemic efficacy than saxagliptin, a DPP4 inhibitor, with additional reductions in weight and systolic blood pressure . Persistence of the benefits of dapagliflozin over saxagliptin may affect the choice of therapy.…”

Mining the sociome for Health Informatics: Analysis of therapeutic lifestyle adherence of diabetic patients in Twitter

“…In the case of T2D, ''Dapagliflozin'' was many times discussed together with ''Farxiga'', ''Sitagliptin'' and ''Saxagliptin'' in the context of results of new T2D therapies [77]. In the case of ''Jardiance'', most of the attention related to news talking about the development of complications due to certain drug combinations, namely ''Gangrene'' and ''Infection'' ( Fig.…”

Revisão sobre a eficácia e segurança no uso de inibidores de co-transportadores de sódio-glicose-2 na fisiopatologia da diabetes mellitus tipo II

“…Os desfechos demonstrados foram reduções maiores de HbA1c, glicemia em jejum, peso corporal e pressão arterial sistólica pela dapagliflozina em comparação a saxagliptina. Entretanto, os pacientes com dapagliflozina (cerca de 6%) apresentaram infecções genitais, em comparação a 0,6% do grupo com saxagliptina (ROSENSTOCK et al, 2018).…”