Similar effectiveness of dapagliflozin and GLP‐1 receptor agonists concerning combined endpoints in routine clinical practice: A multicentre retrospective study. Issue 8 (8th May 2019)

• Record Type: Journal Article
• Authors: Fadini, Gian Paolo; Sciannameo, Veronica; Franzetti, Ivano; Bottigliengo, Daniele; D'Angelo, Paola; Vinci, Carmela; Berchialla, Paola; Arena, Salvatore; Buzzetti, Raffaella; Avogaro, Angelo
• Other Names: Consoli Agostino investigator.; Formoso Gloria investigator.; Grossi Giovanni investigator.; Pucci Achiropita investigator.; Sesti Giorgio investigator.; Andreozzi Francesco investigator.; Capobianco Giuseppe investigator.; Gatti Adriano investigator.; Bonadonna Riccardo investigator.; Zavaroni Ivana investigator.; Cas Alessandra Dei investigator.; Felace Giuseppe investigator.; Volsi Patrizia Li investigator.; Buzzetti Raffaella investigator.; Leto Gaetano investigator.; Sorice Gian Pio investigator.; D'Angelo Paola investigator.; Morano Susanna investigator.; Bossi Antonio Carlo investigator.; Duratorre Edoardo investigator.; Franzetti Ivano investigator.; Morpurgo Paola Silvia investigator.; Orsi Emanuela investigator.; Querci Fabrizio investigator.; Boemi Massimo investigator.; D'Angelo Federica investigator.; Petrelli Massimiliano investigator.; Aimaretti Gianluca investigator.; Karamouzis Ioannis investigator.; Cavalot Franco investigator.; Saglietti Giuseppe investigator.; Cazzetta Giuliana investigator.; Cervone Silvestre investigator.; Devangelio Eleonora investigator.; Lamacchia Olga investigator.; Arena Salvatore investigator.; Di Benedetto Antonino investigator.; Frittitta Lucia investigator.; Giordano Carla investigator.; Piro Salvatore investigator.; Rizzo Manfredi investigator.; Chianetta Roberta investigator.; Mannina Carlo investigator.; Anichini Roberto investigator.; Penno Giuseppe investigator.; Solini Anna investigator.; Fattor Bruno investigator.; Bonora Enzo investigator.; Cigolini Massimo investigator.; Lapolla Annunziata investigator.; Chilelli Nino Cristiano investigator.; Poli Maurizio investigator.; Simioni Natalino investigator.; Frison Vera investigator.; Vinci Carmela investigator.;
• Is Part Of: Diabetes, obesity & metabolism. Volume 21:Issue 8(2019)
• Page Start: 1886
• Page End: 1894
• Publication Date: 2019-05-08
• Subjects: antidiabetic drug -- dapagliflozin -- GLP‐1 analogue -- glycaemic control -- observational study; Diabetes -- Periodicals; Obesity -- Periodicals; Metabolism -- Disorders -- Periodicals; Clinical pharmacology -- Periodicals; 616.462
• DOI: 10.1111/dom.13747
• Languages: English
• ISSNs: 1462-8902

Abstract

Abstract: Aims: According to cardiovascular outcome trials, some sodium‐glucose contransporter‐2 inhibitors (SGLT2i) and glucagon‐like peptide‐1 receptor agonists (GLP‐1RA) are recommended for secondary cardiovascular prevention in type 2 diabetes (T2D). In this real‐world study, we compared the simultaneous reductions in HbA1c, body weight and systolic blood pressure after initiation of dapagliflozin or GLP‐1RA as second or a more advanced line of therapy. Materials and methods: DARWIN‐T2D was a retrospective multi‐centre study conducted at diabetes specialist clinics in Italy that compared T2D patients who initiated dapagliflozin or GLP‐1RA (exenatide once weekly or liraglutide). Data were collected at baseline and at the first follow‐up visit after 3 to 12 months. The primary endpoint was the proportion of patients achieving a simultaneous reduction in HbA1c, body weight and systolic blood pressure. To reduce confounding, we used multivariable adjustment (MVA) or propensity score matching (PSM). Results: Totals of 473 patients initiating dapagliflozin and 336 patients initiating GLP‐1RA were included. The two groups differed in age, diabetes duration, HbA1c, weight and concomitant medications. The median follow‐up was 6 months in both groups. Using MVA or PSM, the primary endpoint was observed in 30% to 32% of patients, with no difference between groups. Simultaneous reduction of HbA1c, BP and SBP by specific threshold, as well as achievement of final goals, did not differ between groups. GLP‐1RA reduced HbA1c by 0.3% more than the reduction achieved with dapagliflozin. Conclusion: In routine specialist care, initiation of dapagliflozin can be as effective as initiation of a GLP‐1RA for attainment of combined risk factor goals.