Comparative efficacy of sodium glucose cotransporter-2 inhibitors in the management of type 2 diabetes mellitus:A real-world experience  

作　　者：Lubna Islam Dhanya Jose Mohammed Alkhalifah Dania Blaibel Vishnu Chandrabalan Joseph M Pappachan 

机构地区：[1]Department of Endocrinology and Metabolism,Lancashire Teaching Hospitals NHS Trust,Preston PR29HT,United Kingdom [2]Department of Community Medicine,Goa Medical College,Goa 403202,India [3]Department of Family Medicine,King Faisal Specialist Hospital,Riyadh 11564,Saudi Arabia [4]Department of Data Science,Lancashire Teaching Hospitals NHS Trust,Preston PR29HT,United Kingdom [5]Faculty of Science,Manchester Metropolitan University,All Saints Building,Manchester M156BH,United Kingdom [6]Faculty of Biology,Medicine and Health,The University of Manchester,Manchester M139PL,United Kingdom

出　　处：《World Journal of Diabetes》2024年第3期463-474,共12页世界糖尿病杂志（英文版）（电子版）

摘　　要：BACKGROUND Sodium glucose cotransporter-2 inhibitors(SGLT-2i)are a class of drugs with modest antidiabetic efficacy,weight loss effect,and cardiovascular benefits as proven by multiple randomised controlled trials(RCTs).However,real-world data on the comparative efficacy and safety of individual SGLT-2i medications is sparse.AIM To study the comparative efficacy and safety of SGLT-2i using real-world clinical data.METHODS We evaluated the comparative efficacy data of 3 SGLT-2i drugs(dapagliflozin,canagliflozin,and empagliflozin)used for treating patients with type 2 diabetes mellitus.Data on the reduction of glycated hemoglobin(HbA1c),body weight,blood pressure(BP),urine albumin creatinine ratio(ACR),and adverse effects were recorded retrospectively.RESULTS Data from 467 patients with a median age of 64(14.8)years,294(62.96%)males and 375(80.5%)Caucasians were analysed.Median diabetes duration was 16.0(9.0)years,and the duration of SGLT-2i use was 3.6(2.1)years.SGLT-2i molecules used were dapagliflozin 10 mg(n=227;48.6%),canagliflozin 300 mg(n=160;34.3%),and empagliflozin 25 mg(n=80;17.1).Baseline median(interquartile range)HbA1c in mmol/mol were:dapagliflozin-78.0(25.3),canagliflozin-80.0(25.5),and empagliflozin-75.0(23.5)respectively.The respective median HbA1c reduction at 12 months and the latest review(just prior to the study)were:66.5(22.8)&69.0(24.0),67.0(16.3)&66.0(28.0),and 67.0(22.5)&66.5(25.8)respectively(P<0.001 for all comparisons from baseline).Significant improvements in body weight(in kilograms)from baseline to study end were noticed with dapagliflozin-101(29.5)to 92.2(25.6),and canagliflozin 100(28.3)to 95.3(27.5)only.Significant reductions in median systolic and diastolic BP,from 144(21)mmHg to 139(23)mmHg;(P=0.015),and from 82(16)mmHg to 78(19)mmHg;(P<0.001)respectively were also observed.A significant reduction of microalbuminuria was observed with canagliflozin only[ACR 14.6(42.6)at baseline to 8.9(23.7)at the study end;P=0.043].Adverse effects of SGLT-2i were as follows:genital thrush and ur

关 键 词：Sodium glucose cotransporter-2 inhibitors Empagliflozin Canagliflozin DAPAGLIFLOZIN Type 2 diabetes mellitus Cardiovascular disease Albumin creatinine ratio DIABESITY 

分 类 号：R587.2[医药卫生—内分泌] R541.6[医药卫生—内科学]