Real-world effectiveness and safety of dapagliflozin therapy added to a GLP1 receptor agonist in patients with type 2 diabetes

Jan 13, 2017Nutrition, metabolism, and cardiovascular diseases : NMCD

Effectiveness and safety of adding dapagliflozin to GLP-1 treatment in people with type 2 diabetes

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Abstract

Dapagliflozin treatment resulted in a 0.51% reduction in A1C levels over 12 months for patients on GLP1-RA therapy.

Both cohorts experienced significant reductions in A1C at 6 and 12 months, with the GLP1-RA group showing decreases of -0.51% and -0.34%, while the non-GLP1-RA group had reductions of -0.69% and -0.62%.
Weight loss was significant in both groups, with the GLP1-RA group losing -2.3 kg and -2.4 kg, compared to the non-GLP1-RA group, which lost -3.9 kg and -4.8 kg at 6 and 12 months, respectively.
Patients receiving GLP1-RA therapy experienced less A1C reduction and weight loss compared to those not on GLP1-RA.
Discontinuation rates of dapagliflozin were similar between the two treatment cohorts.

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BACKGROUND AND AIM: To evaluate the effectiveness and safety of a sodium-glucose cotransporter-2 (SGLT-2) inhibitor, dapagliflozin, in patients with type 2 diabetes mellitus (T2DM) and background glucagon-like peptide-1 receptor agonist (GLP1-RA) therapy.

METHODS AND RESULTS: This is a 12-month, real-world observational study, which assessed the effectiveness and safety of dapagliflozin in patients with T2DM and background GLP1-RA therapy. The main outcome measures were changes in A1C and weight at 6 and 12 months from baseline. Secondary outcomes were differences in A1C and weight reduction between this cohort and another group of patients with T2DM treated with dapagliflozin but without background GLP1-RA therapy. In total, 109 patients with GLP1-RA and 104 patients without GLP1-RA were included. Baseline mean A1C and weight in the GLP1-RA and non-GLP1-RA groups were 7.4% vs. 7.3% and 96.2 kg vs. 95.1 kg, respectively. A significant reduction in A1C was seen with dapagliflozin in both cohorts at 6 and 12 months (GLP1-RA: -0.51% and -0.34%, non-GLP1-RA: -0.69% and -0.62%, respectively, p < 0.0001 in all analyses). Weight was significantly reduced in both groups at 6 and 12 months (GLP1-RA: -2.3 kg and -2.4 kg, non-GLP1-RA: -3.9 kg and -4.8 kg, respectively, p < 0.0001 in all analyses). A1C reduction and weight loss were significantly lower in patients with GLP1-RA than in patients without GLP1-RAs. Drug discontinuation rates were similar in both cohorts.

CONCLUSIONS: Dapagliflozin, when added in real life to patients with T2DM treated with GLP1-RAs, induced a further significant, albeit modest improvement in A1C and a further weight loss.

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Real-world effectiveness and safety of dapagliflozin therapy added to a GLP1 receptor agonist in patients with type 2 diabetes

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