Comparing SGLT-2 inhibitors to DPP-4 inhibitors as an add-on therapy to metformin in patients with type 2 diabetes: A systematic review and meta-analysis

Diabetes & Metabolism
Basem M MishrikyDoyle M Cummings

Abstract

Our aim was to compare Sodium-glucose co-transporter 2 inhibitors (SGLT-2i) to Dipeptidyl peptidase-4 inhibitors (DPP-4i) as add-on therapy to metformin. We searched for randomized trials comparing SGLT-2i to DPP-4i as add-on therapy to metformin in Type 2 diabetes.We pooled trials reporting outcomes between 12 and 26 weeks together while trials reporting results ≥52 weeks were pooled together. The primary outcomes were the change in haemoglobin A1c (A1c) at ≤26 and ≥52 weeks. Sensitivity analyses were performed according to the dose of SGLT-2i and according to baseline A1c for the primary outcomes. Seven trials met our inclusion criteria. There was a statistically significant reduction in A1c at ≥52 weeks favouring SGLT-2i compared to DPP-4i (MD [95% CI]=-0.11% [-0.20, -0.03]) but no significant difference at ≤26 weeks (MD [95% CI]=-0.05% [-0.16, 0.05]). SGLT-2i caused significantly more weight loss compared to DPP-4i at ≤26 weeks and ≥52 weeks (MD [95% CI]=-2.31kg [-2.66, -1.96] and -2.45kg [-2.83, -2.07], respectively). SGLT-2i treated patients had a significantly more genital infection compared to DPP-4i. On restricting the analysis according to the SGLT-2i FDA-approved dose, only higher doses at ≥52 weeks showed a statisti...Continue Reading

Citations

Feb 16, 2019·British Journal of Clinical Pharmacology·Arintaya PhrommintikulNipon Chattipakorn
Jun 1, 2019·Expert Opinion on Drug Safety·Elizabeth Mary LamosStephen N Davis
Feb 2, 2019·Diabetes Therapy : Research, Treatment and Education of Diabetes and Related Disorders·Awadhesh Kumar SinghViswanathan Mohan
May 10, 2020·Diabetes, Obesity & Metabolism·Anat FisherUNKNOWN Canadian Network for Observational Drug Effect Studies (CNODES) Investigators
Dec 19, 2020·Chronic Diseases and Translational Medicine·Fan YangDa-Long Zhu
Aug 3, 2021·International Journal of General Medicine·Awadhesh K SinghPartha Pratim Chakraborty

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