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Dapagliflozin Plus ...
Dapagliflozin Plus Saxagliptin Add-on Therapy Compared With Insulin in Patients With Type 2 Diabetes Poorly Controlled by Metformin With or Without Sulfonylurea Therapy: A Randomized Clinical Trial
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Vilsboll, T. (author)
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Ekholm, E. (author)
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Johnsson, E. (author)
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Dronamraju, N. (author)
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Jabbour, S. (author)
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- Lind, Marcus, 1976 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin,Institute of Medicine
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(creator_code:org_t)
- 2019-06-04
- 2019
- English.
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In: Diabetes Care. - : American Diabetes Association. - 0149-5992 .- 1935-5548. ; 42:8, s. 1464-1472
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https://care.diabete...
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https://gup.ub.gu.se...
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https://doi.org/10.2...
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Abstract
Subject headings
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- OBJECTIVE This study evaluated whether an oral combination of a sodium-glucose cotransporter 2 inhibitor and a dipeptidyl peptidase 4 inhibitor achieved glycemic control similar to basal insulin in patients with type 2 diabetes, poorly controlled with metformin, without increasing hypoglycemia or body weight. RESEARCH DESIGN AND METHODS In a multinational, open-label, randomized, phase 3 trial ( reg. no. ), adults with type 2 diabetes inadequately controlled on metformin, with or without sulfonylurea, were randomized (1:1) to receive dapagliflozin (DAPA) plus saxagliptin (SAXA) or titrated insulin glargine (INS). The primary end point was change in glycated hemoglobin A(1c) (HbA(1c)) from baseline to week 24. DAPA + SAXA treatment was tested for noninferiority versus INS. RESULTS The efficacy data set included 643 patients (mean +/- SD HbA(1c), 9.1 +/- 1.0% [75 +/- 11 mmol/mol]). At week 24, DAPA + SAXA treatment versus INS resulted in noninferior reductions in HbA(1c) (adjusted mean +/- SE change, -1.7 +/- 0.1% vs. -1.5 +/- 0.1% [18.3 +/- 0.7 mmol/mol vs. 16.8 +/- 0.7 mmol/mol]; P = 0.118), significantly different body weight change (between-group difference, -3.64 kg [95% CI -4.20 to -3.09]; P < 0.001), fewer patients with confirmed hypoglycemia (21.3% vs. 38.4%, P < 0.001), more patients achieving HbA(1c) <7.0% (53 mmol/mol) without hypoglycemia (20.9% vs. 13.1%, P = 0.008), and a similar proportion of patients achieving HbA(1c) <7.0% (33.2% vs. 33.5%, P = 0.924). Mean reductions in 24-h glucose measurements from baseline to week 2 were greater with DAPA + SAXA than with INS (P < 0.0001). No patients in the DAPA + SAXA group and three patients (0.9%) in the INS group experienced severe hypoglycemia. CONCLUSIONS Adding DAPA + SAXA to insulin-naive patients with poorly controlled type 2 diabetes achieved similar glycemic control, a lower risk of hypoglycemia, and a clinically relevant body weight difference compared with basal INS.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Endokrinologi och diabetes (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Endocrinology and Diabetes (hsv//eng)
Keyword
- inadequate glycemic control
- glucose-lowering drugs
- double-blind
- cvd-real
- management
- inhibitors
- hyperglycemia
- association
- monotherapy
- statement
- Endocrinology & Metabolism
Publication and Content Type
- ref (subject category)
- art (subject category)
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