Long-term effectiveness and safety of quadruple combination therapy with empagliflozin versus dapagliflozin in patients with type 2 diabetes: 3-year prospective observational study

Ku, Eu Jeong; Lee, Dong Hwa; Jeon, Hyun Jeong; Oh, Tae Keun

doi:10.1016/j.diabres.2021.109123

Cited by 20 publications

(17 citation statements)

References 38 publications

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“…Regarding the risk of ischemic events, a prospective observational study by Ku et al found that empagliflozin resulted in better glycemic control and improvements in cardiometabolic components than that with dapagliflozin among patients with type 2 diabetes (17, 18). Similarly, in the present study, we found that HbA1c levels were significantly lower in the empagliflozin group than in the dapagliflozin and control groups.…”

Section: Discussionmentioning

confidence: 99%

“…However, a few retrospective studies have suggested differences in effects between SGLT2i, favoring the use of dapagliflozin over empagliflozin in terms of HF prevention (15, 16). On the other hand, a few studies have indicated more favorable glycemic control and management of cardiometabolic parameters with empagliflozin than with dapagliflozin (17, 18). Despite potential differences in benefit profiles, no trial has directly compared these SGLT2i in terms of clinical outcomes.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of cardiovascular and renal outcomes between dapagliflozin and empagliflozin in patients with type 2 diabetes

Lim

Hwang

Choi

et al. 2022

Preprint

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Background: The cardiovascular and renal benefits of sodium glucose co-transporter 2 inhibitors (SGLT2i) have been clearly demonstrated. However, studies comparing the effects of dapagliflozin and empagliflozin are scarce. Therefore, we aimed to compare the clinical outcomes between dapagliflozin and empagliflozin in patients with type 2 diabetes without prior atherosclerotic cardiovascular disease, chronic kidney disease, or heart failure. Methods: Using a propensity-score matching method, we retrospectively analyzed 921 patients treated with dapagliflozin, 921 patients treated with empagliflozin, and 1842 patients treated with dipeptidyl peptidase-4 inhibitors (DPP4i; control group). Study outcomes comprised composite coronary events (acute coronary syndrome and coronary revascularization), composite ischemic events (coronary events and stroke), and composite heart failure and renal events. Results: During follow up (median, 43.4 months), the incidence of composite coronary events was significantly lower in the SGLT2i groups than in the control group, and the incidence of composite ischemic events was lower in the dapagliflozin group than in the control group. Dapagliflozin and empagliflozin both demonstrated significant benefits in terms of heart failure and renal outcomes, supported by renoprotective effects, as assessed by the change in glomerular filtration rate. At 24–36 months of treatment, the empagliflozin group had higher low-density lipoprotein cholesterol levels, and lower glycated hemoglobin levels, compared to those in the dapagliflozin and control groups. Conclusion : SGLT2i use was associated with a significantly reduced risk of atherosclerotic cardiovascular events, heart failure hospitalization, and renal events, compared to that with DPP4i use. There were no significant differences in clinical outcomes between dapagliflozin and empagliflozin, supporting a SGLT2i class effect.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparison of cardiovascular and renal outcomes between dapagliflozin and empagliflozin in patients with type 2 diabetes

Lim

Hwang

Choi

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…Moreover, dapagliflozin was compared with empagliflozin as an add-on treatment in patients with T2DM already receiving metformin, glimepiride and DPP-4i. However, between-group comparison did not demonstrate significant changes in LFTs [ 72 ].…”

Section: Combination Treatment Of Nafldmentioning

confidence: 99%

Combination Therapies for Nonalcoholic Fatty Liver Disease

Makri

Polyzos

2022

JPM

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Nonalcoholic fatty liver disease (NAFLD) is considered a highly prevalent disease associated with various co-morbidities that lead to socioeconomic burden. Despite large-scale investigation, no pharmacological treatment has been approved specifically for NAFLD to date. Lifestyle modifications and diet are regarded as highly beneficial for the management of NAFLD, albeit with poor compliance, thus rendering pharmacological treatment highly important. Based on the current failure to discover a “magic bullet” to treat all patients with NAFLD and considering the multifaceted pathophysiology of the disease, combination therapies may be considered to be a rational alternative approach. In this regard, several drug categories have been considered, including, but not limited to, lipid-lowering, anti-hypertensive, glucose-lowering, anti-obesity, anti-oxidant, anti-inflammatory and anti-fibrotic medications. The aim of this review is, in addition to summarizing some of the multiple factors contributing to the pathophysiology of NAFLD, to focus on the efficacy of pharmacological combinations on the management of NAFLD. This may provide evidence for a more personalized treatment of patients with NAFLD in the future.

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“…Dapagliflozin and empagliflozin exhibit quite similar oral bioavailability (78% respectively 60%), but empagliflozin is twice as selective as dapagliflozin (2500-fold vs. 1200-fold compared to SGLT1i action) [ 14 ]. SGLT-2 inhibitors decrease the fasting plasma glucose (FPG) postprandial plasma glucose levels, and the level of glycosylated hemoglobin (HbA1c), in an insulin-independent manner, in addition to reducing body weight via secondary caloric loss due to urinary glucose excretion [ 15 , 16 , 17 , 18 ]. However, for some T2DM patients, the effects of SGLT2i on glycemic control or body weight loss seem to be limited during treatment with this class of antihyperglycemic agents [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

“…Recently, a retrospective study on Korean patients reported that a higher baseline of glycated hemoglobin (HbA1c) levels and preserved estimated glomerular filtration rate (eGFR) were predictive markers of better glycemic responses to dapagliflozin [ 24 ]; specifically, female and obese T2DM patients tended to lose more weight during the treatment with this SGLT-2i [ 15 ]. Another study revealed that the glucose-lowering effect of empagliflozin was more evident in T2DM patients with higher baseline HbA1c levels, better renal function, and shorter T2DM duration.…”

Section: Introductionmentioning

confidence: 99%

Clinical Parameters Affecting the Therapeutic Efficacy of SGLT-2—Comparative Effectiveness and Safety of Dapagliflozin and Empagliflozin in Patients with Type 2 Diabetes

et al. 2022

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(1) Background. We aimed to assess long-term efficacy and safety in inadequately controlled type 2 diabetes (T2DM) of two SGLT-2 inhibitors: empagliflozin (Empa) and dapagliflozin (Dapa), combined with metformin, other oral antidiabetics or insulin, according to the protocols in Romania. (2) Methods. The data of 100 patients treated for T2DM with associated dyslipidemia and/or cardiovascular diseases at the University Hospital and Consultmed Medical Center in Iasi were retrospectively reviewed (2017–2021). In total, 48 patients had received dapagliflozin (10 mg with oral antidiabetics or insulin) and 52 patients received empagliflozin (10 mg /25 mg with oral antidiabetics). (3) Results. In both groups, the lowering of BMI was significant: Dapa group (32.04 ± 4.49 vs. 31.40 ± 4.18 kg/m2; p = 0.006), and Empa group (34.16 ± 5.08 vs. 33.17 ± 4.99 kg/m2; p = 0.002). Blood sugar average levels decreased significantly (170 vs. 136 mg/dL; p = 0.001 for Dapa; 163 vs. 140 mg/dL; p = 0.002 for Empa) and also average levels of HbA1c (7.90% vs. 7.51%; p = 0,01 for Dapa; 7.72% vs. 7.35%; p = 0.004 for Empa). (4) Conclusions. Better results in all variables were observed in younger male patients with a shorter duration of diabetes and threshold BMI levels of 34.1, treated with SGLT2, and more significantly with Empa.

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Long-term effectiveness and safety of quadruple combination therapy with empagliflozin versus dapagliflozin in patients with type 2 diabetes: 3-year prospective observational study

Cited by 20 publications

References 38 publications

Comparison of cardiovascular and renal outcomes between dapagliflozin and empagliflozin in patients with type 2 diabetes

Comparison of cardiovascular and renal outcomes between dapagliflozin and empagliflozin in patients with type 2 diabetes

Combination Therapies for Nonalcoholic Fatty Liver Disease

Clinical Parameters Affecting the Therapeutic Efficacy of SGLT-2—Comparative Effectiveness and Safety of Dapagliflozin and Empagliflozin in Patients with Type 2 Diabetes

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