Dapagliflozin + saxagliptin + metformin combo may reduce HbA1c in T2D
Adding dapagliflozin and saxagliptin to metformin may reduce HbA1c levels in patients with uncontrolled type 2 diabetes (T2D), according to a study presented at EASD 2017.
Four hundred and sixty one patients (mean age 55.9 years, 45.6 percent male, mean body mass index 33.1 kg/m2) with T2D for 8 years (mean HbA1c 8.8 percent) were randomized to triple therapy (n=232, dapagliflozin [10 mg/day] + saxagliptin [5 mg/day] + metformin [≥1,500 mg/day]) or dual therapy (n=229, sitagliptin [100 mg/day] + metformin) for 26 weeks. [EASD 2017, abstract 40]
A significant reduction in HbA1c level was noted in patients treated with triple therapy compared with dual therapy (-1.41 percent vs -1.07 percent) at 26 weeks.
The benefit of triple vs dual therapy in HbA1c reduction was evident regardless of patient’s age (-1.4 percent vs -1.0 percent [age <65 years] and -1.4 percent vs -1.3 percent [age ≥65 years]) or gender (-1.4 percent vs -1.2 percent [males] and -1.4 percent vs -1.0 percent [females]).
In addition, bigger reductions in total body weight and fasting plasma glucose were noted at 26 weeks in patients who received triple therapy than dual therapy (-1.9 vs -0.5 kg and -32 vs -11 mg/dL, respectively).
At 26 weeks, more patients on triple therapy than dual therapy achieved HbA1c <7 percent (37 percent vs 25 percent).
Urinary tract infections were more frequent in patients on triple therapy compared with dual therapy (4.7 percent vs 2.2 percent).
“Improvements in HbA1c with [the] addition of once daily dapagliflozin + saxagliptin [to] metformin were greater than with [the] addition of sitagliptin alone and were achieved regardless of [the patient’s] baseline HbA1c, age, sex, race, and region,” said lead author Professor Stefano Del Prato from the University of Pisa School of Medicine and Chief of the Section of Diabetes at the University of Pisa, Italy.Overall, triple therapy was well tolerated, and no patient experienced a major episode of hypoglycaemia, Del Prato added.