Browse > Article
http://dx.doi.org/10.24304/kjcp.2017.27.2.99

Comparisons of Efficacy between Dapagliflozin and Sitagliptin in Combination with Metformin in Type 2 Diabetes Mellitus Patients  

Kang, Bo Kyeong (Graduate School of Clinical & Public Health Convergence, Ewha Womans University)
An, Sook Hee (College of Pharmacy, Wonkang University)
Kim, Jae Youn (Division of Pharmaceutical Services, Asan Medical Center)
Gwak, Hye Sun (Graduate School of Clinical & Public Health Convergence, Ewha Womans University)
Publication Information
Korean Journal of Clinical Pharmacy / v.27, no.2, 2017 , pp. 99-104 More about this Journal
Abstract
Objectives: This study aimed to compare effects on glycemic control and weight loss between the metformin/dapagliflozin combination and the metformin/sitagliptin combination in type 2 diabetic patients. Methods: This study retrospectively reviewed the medical records, from January $1^{st}$ 2015 to March $31^{st}$ 2016, of type 2 diabetic patients who were older than 18 and were prescribed with dapagliflozin or sitagliptin in combination with metformin. Hemoglobin $A_{1c}$ ($HbA_{1c}$) levels and weights were measured every 3 months. Results: The dapagliflozin group showed a greater decrease in $HbA_{1c}$ levels after 3 months (-0.75% vs. 0.01%, P<0.001), 6 months (-0.36% vs. 0.08%, P=0.029), and 9 months (-0.53% vs. 0.08%, P=0.046) compared to the sitagliptin group. Also, the dapagliflozin group showed a greater significant decrease in the rate of change in $HbA_{1c}$ levels after 3 months (-0.09 vs. 0.01, P<0.001), 6 months (-0.04 vs. 0.01, P=0.031), 9 months (-0.07 vs. 0.02, P=0.029), and 12 months (-0.05 vs. 0.05, P=0.047). Furthermore, the dapagliflozin group showed a greater decrease in amount of weight change after 3 months (-2.46 kg vs. 0.37 kg, P<0.001), 6 months (-3.02 kg vs. 0.13 kg, P<0.001), and 9 months (-2.27 kg vs. 0.50 kg, P=0.002). Finally, the dapagliflozin group showed a greater decrease in the rate of change in weight after 3 months (-3.10% vs. 0.52%, P<0.001), 6 months (-3.83% vs. 0.21%, P<0.001), 9 months (-2.84% vs. 0.79%, P=0.002), and 12 months (-4.91% vs. 0.44%, P<0.001). Conclusions: It was concluded that dapagliflozin is more effective than sitagliptin for type 2 diabetic patients.
Keywords
Dapagliflozin; sitagliptin; metformin; glycemic control; weight loss;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Available form http://kostat.go.kr/portal/korea/index.action. Accessed April 12, 2017.
2 Schellenberg ES, Dryden DM, Vandermeer B, Ha C, Korownyk C. Lifestyle Interventions for Patients With and at Risk for Type 2 DiabetesA Systematic Review and Meta-analysis. Ann Intern Med 2013;159(8):543-51.   DOI
3 Tuomilehto J, Lindstrom J, Eriksson JG, et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med 2001;344(18):1343-50.   DOI
4 Holman RR, Paul SK, Bethel MA, Matthews DR, Neil HA. 10-year follow-up of intensive glucose control in type 2 diabetes. N Engl J Med 2008;359(15):1577-89.   DOI
5 Oh JY. Treatment guideline for diabetes. Korean J Intern Med 2008;75(3):249-56.
6 FDA(R), Available form http://www.accessdata.fda.gov/scripts/cder/ drugsatfda. Accessed April 12, 2017.
7 Kimsonline(R), Available form http://www.kimsonline.co.kr. Accessed April 12, 2017.
8 Uptodate(R), Available form http://www.uptodate.com. Accessed April 12, 2017.
9 Bailey CJ, Gross JL, Pieters A, Bastien A. List J.F. Effect of dapagliflozin in patients with type 2 diabetes who have inadequate glycaemic control with metformin: a randomized, double-blind, placebo-controlled trial. Lancet 2010;375(9733):2223-33.   DOI
10 Bailey CJ, Gross JL, Hennicken D, et al. Dapagliflozin addon to metformin in type 2 diabetes inadequately controlled with metformin: a randomized, double-blind, placebo-controlled 102-week trial. BMC Med 2013;11:193.   DOI
11 Bolinder J, Ljunggren O, Kullberg J, et al. Effects of dapagliflozin on body weight, total fat mass, and regional adipose tissue distribution in patients with type 2 diabetes mellitus with inadequate glycemic control on metformin. J Clin Endocrinol Metab 2012;97(3):1020-31.   DOI
12 Strojek K, Yoon KH, Hruba V, Elze M, Langkilde AM, Parikh S. Effect of dapagliflozin in patients with type 2 diabetes who have inadequate glycaemic control with glimepiride: a randomized, 24-week, double-blind, placebo-controlled trial. Diabetes Obes Metab 2011;13(10):928-38.   DOI
13 Rosenstock J, Vico M, Wei L, Salsali A, List JF. Effects of dapagliflozin, an SGLT2 inhibitor, on HbA(1c), body weight, and hypoglycemia risk in patients with type 2 diabetes inadequately controlled on pioglitazone monotherapy. Diabetes Care 2012;35(7):1473-8.   DOI
14 Jabbour SA, Hardy E, Sugg J, Parikh S. Dapagliflozin is effective as add-on therapy to sitagliptin with or without metformin: a 24 week, multicenter, randomized, double-blind, placebo-controlled study. Diabetes Care 2014;37(3):740-50.   DOI
15 Ferrannini E, Ramos SJ, Salsali A, Tang W, List JF. Dapagliflozin in monotherapy in type 2 diabetes patients with inadequate glycemic control by diet and exercise: a randomized, double-blind, placebocontrolled, phase 3 trial. Diabetes Care 2010;33(10):2217-24.   DOI
16 Zhang Y, Hong J, Chi J, et al. Head-to-head comparison of dipeptidyl peptidase-IV inhibitors and sulfonylureas - a meta-analysis from randomized clinical trials. Diabetes Metab Res Rev 2014;30(3):241-56.   DOI
17 Skolnik N, Bonnes H, Yeh H, Katz A. Dapagliflozin in the treatment of patients with type 2 diabetes presenting with high baseline A1C. Postgrad Med 2016;128(4):356-63.   DOI
18 Karagiannis T, Paschos P, Paletas K, et al. Dipeptidyl peptidase-4 inhibitors for treatment of type 2 diabetes mellitus in the clinical setting: systematic review and meta-analysis. BMJ 2012;344:e1369-83.   DOI
19 DeFronzo RA, Stonehouse AH, Han J, et al. Relationship of baseline HbA1c and efficacy of current glucose-lowering therapies: a metaanalysis of randomized clinical trials. Diabet Med 2010;27(3):309-17.   DOI
20 Bloomgarden ZT, Dodis R, Viscoli CM, et al. Lower baseline glycemia reduces apparent oral agent glucose-lowering efficacy. Diabetes Care 2006;29(9):2137-9.   DOI
21 Grandy S, Hashemi M, Langkilde AM, Parikh S, Sjostrom CD. Changes in weight loss-related quality of life among type 2 diabetes mellitus patients treated with dapagliflozin. Diabetes Obes Metab. 2014;16(7):645-50.   DOI