Similar effectiveness of dapagliflozin and GLP-1 receptor agonists concerning combined endpoints in routine clinical practice: A multicentre retrospective study
- Authors: Fadini G.P.; Sciannameo V.; Franzetti I.; Bottigliengo D.; D'Angelo P.; Vinci C.; Berchialla P.; Arena S.; Buzzetti R.; Avogaro A.; Consoli A.; Formoso G.; Grossi G.; Pucci A.; Sesti G.; Andreozzi F.; Capobianco G.; Gatti A.; Bonadonna R.; Zavaroni I.; Cas A.D.; Felace G.; Volsi P.L.; Buzzetti R.; Leto G.; Sorice G.P.; D'Angelo P.; Morano S.; Bossi A.C.; Duratorre E.; Franzetti I.; Morpurgo P.S.; Orsi E.; Querci F.; Boemi M.; D'Angelo F.; Petrelli M.; Aimaretti G.; Karamouzis I.; Cavalot F.; Saglietti G.; Cazzetta G.; Cervone S.; Devangelio E.; Lamacchia O.; Arena S.; Di Benedetto A.; Frittitta L.; Giordano C.; Piro S.; Rizzo M.; Chianetta R.; Mannina C.; Anichini R.; Penno G.; Solini A.; Fattor B.; Bonora E.; Cigolini M.; Lapolla A.; Chilelli N.C.; Poli M.; Simioni N.; Frison V.; Vinci C.
- Publication year: 2019
- Type: Articolo in rivista
- OA Link: http://hdl.handle.net/10447/369902
Abstract
Aims: According to 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 a more advanced line of therapy. Materials and methods: DARWIN-T2D was a retrospective multi-centre study conducted at diabetes specialist clinics in Italy that compared T2D patients who initiated dapagliflozin or GLP-1RA (exenatide once weekly or liraglutide). Data were collected at baseline and at the first follow-up visit after 3 to 12 months. The primary endpoint was the proportion of patients achieving a simultaneous reduction in HbA1c, body weight and systolic blood pressure. To reduce confounding, we used multivariable adjustment (MVA) or propensity score matching (PSM). Results: Totals of 473 patients initiating dapagliflozin and 336 patients initiating GLP-1RA were included. The two groups differed in 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, BP and SBP by specific threshold, as well as achievement of final goals, did not differ between groups. GLP-1RA reduced HbA1c by 0.3% more than the reduction achieved with dapagliflozin. Conclusion: In routine specialist care, initiation of dapagliflozin can be as effective as initiation of a GLP-1RA for attainment of combined risk factor goals.