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.
Similar effectiveness of dapagliflozin and GLP-1 receptor agonists concerning combined endpoints in routine clinical practice: A multicentre retrospective study / 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.. - In: DIABETES, OBESITY AND METABOLISM. - ISSN 1462-8902. - 21:8(2019), pp. 1886-1894. [10.1111/dom.13747]
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