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Similar effectiveness of dapagliflozin versus GLP-1 receptor agonists on combined endpoints in routine clinical practice. A multicenter retrospective study

Gian Paolo Fadini, Veronica Sciannameo, Ivano Franzetti, Daniele Bottigliengo, Paola D'Angelo, Carmela Vinci, Paola Berchialla, Salvatore Arena, Raffaella Buzzetti, Angelo Avogaro
Diabetes, Obesity & Metabolism 2019 April 15

BACKGROUND AND AIMS: Based on cardiovascular outcome trials, some sodium-glucose contransporter-2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1RA) are recommended for secondary cardiovascular prevention in type 2 diabetes (T2D). In this real-world study, we compared the simultaneous reductions in HbA1c, body weight, and systolic blood pressure after initiation of dapagliflozin or GLP-1RA as second or more advanced line of therapy.

METHODS: DARWIN-T2D was a retrospective multi-centre study conducted at diabetes specialist clinics in Italy. We herein compared T2D patients who initiated dapagliflozin or GLP-1RA (exenatide once weekly or liraglutide). We collected data at baseline and at the first available visit after 3 to 12 months. The primary endpoint was the proportion of patients achieving a simultaneous reduction of HbA1c, body weight, and systolic blood pressure. To reduce confounding, we used multivariable adjustment (MVA) or propensity score matching (PSM).

RESULTS: 473 patients initiating dapagliflozin and 336 patients initiating GLP-1RA were included. The two groups differed for age, diabetes duration, HbA1c, weight, and concomitant medications. The median follow-up was 6 months in both groups. Using MVA or PSM, the primary endpoint was observed in 30 to 32% of patients, with no difference between groups. Simultaneous reduction of HbA1c, body weight and systolic blood pressure by specific threshold, as well as achievement of final goals, were not different between groups. GLP-1RA reduced HbA1c by 0.3%.more than dapagliflozin.

CONCLUSION: In routine specialist care, initiation of dapagliflozin can be as effective as initiation of a GLP-1RA for the attainment of combined risk factor goals. This article is protected by copyright. All rights reserved.


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