Empagliflozin Vs Dapagliflozin in Type 2 Diabetes Patients Inadequately Controlled with Metformin, Glimepiride & Dipeptidyl Peptide 4 Inhibitors

Diabetes Research and Clinical Practice
10 Apr, 2019 ,

Eu Jeong Ku et al assessed the efficacy and safety of two distinct sodium-glucose cotransporter 2 (SGLT2) inhibitors, empagliflozin vs dapagliflozin, as part of a quadruple oral antidiabetic agents (OADs) regimen. This investigation was conducted in T2D subjects with glycated hemoglobin (HbA1c) from 7.5-12.0% with metformin, glimepiride, and dipeptidyl peptidase-4 inhibitors. For this open-labeled, prospective, 52-week study, patients received either empagliflozin (25 mg/day) or dapagliflozin (10 mg/day). In T2D patients who are treated with three other OADs, SGLT2 inhibitors could be effectively used as a fourth OAD. More specifically, in reducing HbA1c and improving other cardiometabolic parameters, empagliflozin was more effective than dapagliflozin.

 

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Abstract

Aims

To directly compare the effectiveness and safety between two distinct sodium-glucose co-transporter 2 (SGLT2) inhibitors, empagliflozin and dapagliflozin, as part of a quadruple oral antidiabetic agents (OADs) in patients with inadequately controlled type 2 diabetes (T2D).

Methods

This study was an open-labeled, prospective, 52-week study conducted in T2D patients with glycated hemoglobin (HbA1c) ranging 7.5–12.0% with metformin, glimepiride and dipeptidyl peptidase-4 inhibitors. Patients were divided into either empagliflozin (25 mg/day) or dapagliflozin (10 mg/day). The outcome measures included changes in HbA1c, fasting plasma glucose (FPG), and cardiometabolic variables and the safety profiles.

Results

In total, 350 patients were enrolled with empagliflozin (n = 176) and dapagliflozin (n = 174), respectively. After 52 weeks, both groups showed significant reductions in HbA1c and FPG, but the reduction was greater in the empagliflozin group (P < 0.001). Both groups showed significantly decreased blood pressure and body weight and high-density lipoprotein cholesterol levels were increased in the empagliflozin (between groups, P = 0.035). Both groups showed similar safety profiles.

Conclusions

Our study demonstrated that SGLT2 inhibitors can be effectively used as a fourth OAD in T2D patients who are treated with three other OADs. More specifically, empagliflozin was more effective in reducing HbA1c and improving other cardiometabolic parameters than dapagliflozin.