The Association Between the Dosage of SGLT2 Inhibitor and Weight Reduction in Type 2 Diabetes Patients: A Meta‐Analysis

Cai, Xiaoling; Yang, Wenjia; Gao, Xueying; Chen, Yifei; Zhou, Lingli; Zhang, Simin; Han, Xueyao

doi:10.1002/oby.22066

Cited by 138 publications

(112 citation statements)

References 78 publications

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“…These findings indicate that patients with overweight and obesity, including those in the highest BMI category (≥ 35), can benefit from weight loss with ertugliflozin. In a recent meta‐analysis, body weight significantly decreased in patients with T2DM who received different dosages of SGLT2 inhibitors (dapagliflozin, empagliflozin, canagliflozin, ipragliflozin, tofogliflozin, and luseogliflozin) compared with patients who received a placebo, with a greater reduction in body weight with higher doses of SGLT2 inhibitors . Despite the observed maintenance of weight loss in patients with T2DM treated with SGLT2 inhibitors, the observed reduction in body weight tends to plateau after approximately 26 weeks despite sustained urinary glucose excretion, with observed weight loss less than predicted based on caloric loss from urinary glucose excretion .…”

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

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Efficacy and Safety of Ertugliflozin in Patients with Overweight and Obesity with Type 2 Diabetes Mellitus

Heymsfield

Raji

Gallo

et al. 2020

Obesity

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Objective This study aimed to evaluate ertugliflozin in patients with overweight and obesity with type 2 diabetes mellitus. Methods Data from three placebo‐controlled, randomized, Phase 3 studies were pooled. Patients with baseline BMI ≥ 25 (1,377/1,544; 89%) were assessed with a stratification by BMI subgroup. Results At week 26, reductions from baseline in glycated hemoglobin A1c (HbA1c), fasting plasma glucose, body weight (BW), and systolic blood pressure (SBP) were greater with ertugliflozin versus placebo. For placebo, ertugliflozin 5 mg, and ertugliflozin 15 mg, respectively, least squares mean change was 0.1%, −0.8%, and −0.9% for HbA1c and −1.2 kg, −3.1 kg, and −3.2 kg for BW. HbA1c reductions were consistent across BMI subgroups. For ertugliflozin 5 mg and 15 mg, least squares mean change (placebo adjusted) in absolute BW was −1.4 kg and −1.2 kg for BMI 25 to < 30, −1.8 kg and −1.9 kg for BMI 30 to < 35, and −2.5 kg and −2.9 kg for BMI ≥ 35. Percent BW changes were similar across BMI subgroups. Incidence of adverse events was 52.5%, 44.6%, and 50.1% with placebo, ertugliflozin 5 mg, and ertugliflozin 15 mg, respectively. Conclusions Meaningful reductions in HbA1c, fasting plasma glucose, BW, and SBP were observed with ertugliflozin in patients with overweight and obesity with type 2 diabetes mellitus. Ertugliflozin improved HbA1c and SBP and reduced BW across BMI subgroups. Ertugliflozin was generally well tolerated.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Ertugliflozin in Patients with Overweight and Obesity with Type 2 Diabetes Mellitus

Heymsfield

Raji

Gallo

et al. 2020

Obesity

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show abstract

“…Patients with T2D have an increased risk of multiple co‐morbidities, including hypertension, obesity, dyslipidaemia, and CKD . In addition to glycaemic benefits, treatment with SGLT‐2is reduces CV risk factors such as blood pressure and body weight and provides renoprotective effects which, in turn, may have the potential to reduce risk for HF.…”

Section: Multiple Co‐morbidities In Type 2 Diabetesmentioning

confidence: 99%

Use of sodium–glucose co‐transporter‐2 inhibitors in patients with and without type 2 diabetes: implications for incident and prevalent heart failure

Butler

Handelsman

Bakris

et al. 2020

European J of Heart Fail

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Type 2 diabetes (T2D) is associated with an increased risk of heart failure (HF), with recent reports indicating that HF with preserved ejection fraction (HFpEF) may be more common than HF with reduced ejection fraction (HFrEF) in patients with T2D. T2D and HF result in worse outcomes than either disease alone. Sodium–glucose co‐transporter‐2 inhibitors (SGLT‐2is) have significantly improved HF outcomes in patients with T2D and may represent a new therapeutic alternative for patients with T2D at risk for or with HF. Current guidelines recommend prevention of HF through risk factor management. Once developed, treatment of HFrEF should include neurohormonal and haemodynamic modulations; however, there are no specific treatments available for HFpEF. SGLT‐2is are the first class of glucose‐lowering therapy to prevent HF in clinical trials and real‐world studies in patients with T2D (with or without established cardiovascular disease and with or without baseline HF). Mechanistic studies suggest that SGLT‐2is have beneficial effects on both systolic and diastolic function and additional systemic effects that could benefit HF outcomes. In patients with HFrEF, SGLT‐2i treatment as add‐on to standard HF therapy has had beneficial effects on HF outcomes, irrespective of T2D status. These results and those of ongoing outcomes trials with SGLT‐2is may help establish this drug class as a treatment for HF in patients with HFrEF and HFpEF, as well as HF in patients without T2D.

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“…Besides lowering blood glucose, SGLT2i also reduce both body weight and uric acid (UA) levels. SGLT2i‐induced glycosuria diminishes weight through calorie loss.…”

Section: Glycemic and Extra‐glycemic Effects Of Sglt2 Inhibitorsmentioning

confidence: 99%

“…21 Indeed, the primary determinant of tubular glucose reabsorption (or loss in the presence of SGLT2i) is the amount of filtered glucose that depends not only on blood glucose levels but also on renal function. 21 Besides lowering blood glucose, SGLT2i also reduce both body weight 22 and uric acid (UA) levels. SGLT2i-induced glycosuria diminishes weight through calorie loss.…”

Section: Glycemic and Extra-glycemic Effects Of Sglt2 Inhibitorsmentioning

confidence: 99%

SGLT2 inhibition to address the unmet needs in diabetic nephropathy

Barutta

Bernardi

Gargiulo

et al. 2019

Diabetes Metabolism Res

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Summary Current treatment of diabetic nephropathy is effective; however, substantial gaps in care still remain and new therapies are urgently needed to reduce the global burden of the complication. Desirable properties of an “ideal” new drug should include primary prevention of microalbuminuria, additive/synergistic anti‐proteinuric effect in combination therapy with renin angiotensin system blockers, reduction of chronic kidney disease progression to lower the risk of end‐stage renal disease, and cardiovascular protection. Growing evidence suggests that sodium‐glucose cotransporter 2 inhibitors (SGLT2i) may fulfil many of these criteria and represent novel tools to cover the unmet needs in diabetic nephropathy care. However, the underlying mechanisms of SGLT2i renal benefits are still poorly understood and promising results from cardiovascular outcome trials with SGLT2i need confirmation in dedicated renal outcome trials.

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The Association Between the Dosage of SGLT2 Inhibitor and Weight Reduction in Type 2 Diabetes Patients: A Meta‐Analysis

Cited by 138 publications

References 78 publications

Efficacy and Safety of Ertugliflozin in Patients with Overweight and Obesity with Type 2 Diabetes Mellitus

Efficacy and Safety of Ertugliflozin in Patients with Overweight and Obesity with Type 2 Diabetes Mellitus

Use of sodium–glucose co‐transporter‐2 inhibitors in patients with and without type 2 diabetes: implications for incident and prevalent heart failure

SGLT2 inhibition to address the unmet needs in diabetic nephropathy

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