Durability of glycaemic control with dapagliflozin, an SGLT2 inhibitor, compared with saxagliptin, a DPP4 inhibitor, in patients with inadequately controlled type 2 diabetes

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  • Clifford J. Bailey
    School of Life and Health Sciences Aston University Birmingham UK
  • Stefano Del Prato
    Section of Metabolic Diseases and Diabetes, Department of Clinical and Experimental Medicine University of Pisa Pisa Italy
  • Cheryl Wei
    AstraZeneca, R&D Bio Pharmaceuticals, Late CVRM Gaithersburg Maryland
  • Daniel Reyner
    AstraZeneca, R&D Bio Pharmaceuticals, Late CVRM Gaithersburg Maryland
  • Gabriela Saraiva
    AstraZeneca, R&D Bio Pharmaceuticals, Late CVRM Gaithersburg Maryland

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<jats:title>Abstract</jats:title><jats:p>Dapagliflozin is associated with greater reductions in HbA1c and weight than saxagliptin in management of type 2 diabetes mellitus (T2DM). The present <jats:italic>post hoc</jats:italic> analyses compared the durability of these effects over short‐ and long‐term follow‐up in patients with T2DM who were inadequately controlled with metformin (≥1500 mg/day) and who were receiving either dapagliflozin (10 mg/day) or saxagliptin (5 mg/day). Failure of glycaemiccontrol was assessed using the slope of the change in HbA1c from baseline‐over‐time regression line (coefficient of failure [CoF]). CoF was compared directly (dapagliflozin vs saxagliptin) over the short term (NCT01606007, 24 weeks) and indirectly (placebo‐adjusted) over the long term (NCT00528879 and NCT00121667, 102 weeks). A low CoF value indicated greater durability. CoF was lower for dapagliflozin versus saxagliptin over 18–24 weeks (−1.38%/year; 95% CI, −2.41 to −0.35; <jats:italic>P</jats:italic> = .009) and 20–102 weeks (−0.37%/year; 95% CI, −0.73 to −0.02; <jats:italic>P</jats:italic> = .04). Fewer dapagliflozin‐treated patients versus saxagliptin‐treated patients required rescue medication or discontinued the study because of failure to achieve glycaemic control at 24 weeks (3.4% vs 9.4%; <jats:italic>P</jats:italic> = .0191). In patients with T2DM who were inadequately controlled with metformin, dapagliflozin was associated with greater durability of glycaemic control than saxagliptin over 18–24 and 20–102 weeks.</jats:p>

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