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

Clifford J. Bailey, Stefano Del Prato, Cheryl Wei, Daniel Reyner, Gabriela Saraiva

Research output: Contribution to journalArticle

Abstract

Dapagliflozin is associated with greater reductions in HbA1c and weight than saxagliptin in management of type 2 diabetes mellitus (T2DM). The present post hoc analyses compared the durability of these effects over short- and long-term follow-up in patients with T2DM who were inadequately controlled with metformin (≥1500 mg/day) and who were receiving either dapagliflozin (10 mg/day) or saxagliptin (5 mg/day). Failure of glycaemiccontrol was assessed using the slope of the change in HbA1c from baseline-over-time regression line (coefficient of failure [CoF]). CoF was compared directly (dapagliflozin vs saxagliptin) over the short term (NCT01606007, 24 weeks) and indirectly (placebo-adjusted) over the long term (NCT00528879 and NCT00121667, 102 weeks). A low CoF value indicated greater durability. CoF was lower for dapagliflozin versus saxagliptin over 18–24 weeks (−1.38%/year; 95% CI, −2.41 to −0.35; P =.009) and 20–102 weeks (−0.37%/year; 95% CI, −0.73 to −0.02; P =.04). Fewer dapagliflozin-treated patients versus saxagliptin-treated patients required rescue medication or discontinued the study because of failure to achieve glycaemic control at 24 weeks (3.4% vs 9.4%; P =.0191). In patients with T2DM who were inadequately controlled with metformin, dapagliflozin was associated with greater durability of glycaemic control than saxagliptin over 18–24 and 20–102 weeks.

Original languageEnglish
Pages (from-to)2564-2569
Number of pages6
JournalDiabetes, Obesity and Metabolism
Volume21
Issue number11
Early online date31 Jul 2019
DOIs
Publication statusPublished - 1 Nov 2019

Bibliographical note

© 2019 The Authors. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

Funding: AstraZeneca.

Keywords

  • CoF
  • DPP4 inhibitor
  • SGLT2 inhibitor
  • T2DM
  • coefficient of failure
  • dapagliflozin
  • durability
  • glycaemic control
  • saxagliptin
  • type 2 diabetes mellitus

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