Analysis of the effectiveness of second oral glucose-lowering therapy in routine clinical practice from the mediterranean area : A retrospective cohort study
Vlacho, Bogdan (Universitat Autònoma de Barcelona. Departament de Farmacologia, de Terapèutica i de Toxicologia)
Mundet-Tudurí, Xavier (Universitat Autònoma de Barcelona. Departament de Medicina)
Mata-Cases, M. (Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas)
Vallès-Callol, J.A. (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Real, J. (Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas)
Farre, Magi (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Cos Claramunt, Francesc Xavier (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Khunti, K. (Diabetes Research Centre. University of Leicester)
Mauricio Puente, Dídac (Institut d'Investigació Biomèdica Sant Pau)
Franch-Nadal, J. (Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas)
Universitat Autònoma de Barcelona

Date:	2021
Abstract:	Aim: To compare the changes in HbA1c, the effect on body weight or both combined after the addition of a DPP-4i, SGLT-2i, or sulfonylureas (SU) to metformin in real-world condition. Methods: We used a primary care SIDIAP database. The included subjects were matched by propensity score according to baseline age, sex, HbA1c, weight, inclusion date, diabetes duration, and kidney function. Results: Mean absolute HbA1c reduction was: 1. 28% for DPP4i, 1. 29% for SGLT2i and 1. 26% for SU. Mean weight reduction was: 1. 21 kg for DPP4i, 3. 47 kg for SGLT2i and 0. 04 kg for SU. The proportion of patients who achieved combined target HbA1c (≥0. 5%) and weight (≥3%) reductions after the addition of DPP-4i, SGLT-2i or SU, was: 24. 2%, 41. 3%, and 15. 2%, respectively. Small differences in systolic blood pressure reduction (1. 07, 3. 10 and 0. 96 mmHg, respectively) were observed in favour of SGLT-2i. Concerning the lipids, we observed small differences, with an HDL-cholesterol increase with SGLT-2i. Conclusion: Our real-world study showed that the addition of SGLT-2i to metformin was associated with greater reductions in weight and the combination target of weight-HbA1c compared to SU and DPP4 inhibitors. However, similar hypoglycaemic effectiveness was observed among the three-drug classes.
Note:	Altres ajuts: AstraZeneca, Spain [grant number ESR-16-12628]; National Institute for Health Research (NIHR); Applied Research Collaboration East Midlands (ARC EM); NIHR Leicester Biomedical Research Centre (BRC). Instituto de Salud Carlos III (ISCIII); Fondo Investigación sanitaria (FIS); Fondo Europeo de Desarrollo Regional (FEDER).
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	DPP-IV inhibitor ; Glycaemic control ; SGLT2 inhibitor ; Sulphonylureas ; Type 2 diabetes ; Weight control
Published in:	Diabetes research and clinical practice, Vol. 171 (january 2021) , p. 108616, ISSN 1872-8227

DOI: 10.1016/j.diabres.2020.108616
PMID: 33310172

10 p, 1.3 MB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
Articles > Research articles
Articles > Published articles