Diabetes Res Clin Pract. 2023;203:110872.
Comparison of therapeutic efficacy and safety of sitagliptin, dapagliflozin, or lobeglitazone adjunct therapy in patients with type 2 diabetes mellitus inadequately controlled on sulfonylurea and metformin: Third agent study.
제1저자 홍준화 · 교신저자 임수
소속 (4)
- Department of Internal Medicine, Daejeon Eulji Medical Center, Eulji University, Daejeon, Republic of Korea. Electronic address: lammoth@naver.com.
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Republic of Korea. Electronic address: mjs7912@yu.ac.kr.
- Department of Internal Medicine, Daejeon Eulji Medical Center, Eulji University, Daejeon, Republic of Korea. Electronic address: fragrance_ky@naver.com.
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea. Electronic address: limsoo@snu.ac.kr.
Abstract
AIMS Compare the efficacy and safety of sitagliptin, dapagliflozin, and lobeglitazone in patients with uncontrolled type 2 diabetes, despite metformin and sulfonylurea therapy.
METHODS The study randomized patients into three groups, receiving sitagliptin 100 mg, dapagliflozin 10 mg, or lobeglitazone 0.5 mg daily (n = 26 each) and monitored changes in biochemical parameters and body composition for 24 months. The primary efficacy endpoint was changes in HbA1c at 24 months.
RESULTS The mean change in HbA1c in the sitagliptin, dapagliflozin, and lobeglitazone groups was -0.81 ± 0.21%, -1.05 ± 0.70%, and -1.08 ± 0.98%, after 24 months. Dapagliflozin treatment significantly lowered systolic blood pressure by 5.5 mmHg and alanine aminotransferase levels. Dapagliflozin and lobeglitazone treatment significantly reduced proteinuria and insulin resistance. Dapagliflozin decreased whole body fat percentage by 1.2%, whereas sitagliptin and lobeglitazone increased it by 1.1% and 1.8%, respectively. Whole body muscle percentage increased in the dapagliflozin group and decreased in the lobeglitazone group. The safety profiles of the three treatments were comparable.
CONCLUSIONS All three drugs displayed good glucose-lowering efficacy and comparable safety profiles. However, dapagliflozin therapy produced favorable changes in body composition. Dapagliflozin may be a suitable adjunct therapy for patients with type 2 diabetes seeking to improve their body composition.
Copyright © 2023. Published by Elsevier B.V.
Keywords
Body fatDapagliflozinHbA1cLobeglitazoneSitagliptinType 2 diabetes
Conflict of interest statement
Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Soo Lim reports financial support was provided by Korean Diabetes Association.
그 밖의 정보
- 출판 형태
- Journal Article
- 저널
- Diabetes research and clinical practice · eISSN 1872-8227
- 전자 출판
- 2023-08-11
- MeSH
- Humans · Diabetes Mellitus, Type 2* · Sitagliptin Phosphate / adverse effects · Metformin* / adverse effects · Hypoglycemic Agents / adverse effects · Glycated Hemoglobin · Blood Glucose · Sulfonylurea Compounds / therapeutic use · Drug Therapy, Combination · Double-Blind Method · Treatment Outcome · Pyrimidines · Thiazolidinediones · Benzhydryl Compounds · Glucosides
- Substances
- Sitagliptin Phosphate · Metformin · Hypoglycemic Agents · Glycated Hemoglobin · Blood Glucose · Sulfonylurea Compounds · lobeglitazone · Pyrimidines · Thiazolidinediones · dapagliflozin · Benzhydryl Compounds · Glucosides