SGLT2 Inhibitors as Add-On Therapy to Metformin for People with Type 2 Diabetes: A Review of Placebo-Controlled Trials in Asian versus Non-Asian Patients

André J Scheen1,2 1Diabetes, Nutrition and Metabolic Disorders, Department of Medicine, CHU Liège, Liège University, Liège, Belgium; 2Clinical Pharmacology Unit, CHU Liège, Center for Interdisciplinary Research on Medicines (CIRM), Li&egrave...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autor principal:	Scheen AJ
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	blood pressure body weight combined therapy glucose control hba1c oral antidiabetic drug Specialties of internal medicine RC581-951
Acceso en línea:	https://doaj.org/article/22b69cc7d942447788c0e405d101010e
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:22b69cc7d942447788c0e405d101010e
record_format	dspace
spelling	oai:doaj.org-article:22b69cc7d942447788c0e405d101010e2021-12-02T03:27:04ZSGLT2 Inhibitors as Add-On Therapy to Metformin for People with Type 2 Diabetes: A Review of Placebo-Controlled Trials in Asian versus Non-Asian Patients1178-7007https://doaj.org/article/22b69cc7d942447788c0e405d101010e2020-08-01T00:00:00Zhttps://www.dovepress.com/sglt2-inhibitors-as-add-on-therapy-to-metformin-for-people-with-type-2-peer-reviewed-article-DMSOhttps://doaj.org/toc/1178-7007André J Scheen1,2 1Diabetes, Nutrition and Metabolic Disorders, Department of Medicine, CHU Liège, Liège University, Liège, Belgium; 2Clinical Pharmacology Unit, CHU Liège, Center for Interdisciplinary Research on Medicines (CIRM), Liège University, Liège, BelgiumCorrespondence: André J Scheen Email andre.scheen@chuliege.beAbstract: Metformin remains the first pharmacological choice for treating hyperglycemia in type 2 diabetes (T2DM) in most international guidelines. Sodium-glucose cotransporter type 2 inhibitors (SGLT2is) are increasingly used as add-on therapy. T2DM pathophysiology is different in Asian and non-Asian (mainly Caucasian) patients. The aim of this systematic review is to compare the efficacy of SGLT2is vs placebo added to metformin in randomized controlled trials (RCTs: range 12– 52 weeks) in Asian versus non-Asian patients with T2DM. The primary endpoint is the reduction in glycated hemoglobin (HbA1c) from baseline and key secondary endpoints are reductions in fasting plasma glucose (FPG), body weight (BW) and systolic blood pressure (SBP). Systematic literature search collected 7 RCTs (3 with 2 doses) in Asian patients (10 analyses, n=1164, iSGLT2: canagliflozin, dapagliflozin, ertugliflozin, ipragliflozin, tofogliflozin)) and 10 RCTs (6 with two doses) in non-Asian patients (16 analyses, n=2482, iSGLT2: canagliflozin, dapagliflozin, empagliflozin, ertugliflozin, ipragliflozin). Baseline values of HbA1c (7.98± 0.19 vs 7.89± 0.27%), FPG (8.80 ± 0.46 vs 9.11± 0.49 mmol/l) and SBP (128.4± 1.6 vs 130.2± 3.1 mmHg) were not significantly different in Asian vs non-Asian patients, but BW was lower in Asian patients (71.6± 4.8 vs 88.0± 2.5 kg, p< 0.001). The placebo-adjusted weighed mean differences (WMD, 95% CI) were similar in Asian versus non-Asian patients regarding the reductions in HbA1c − 0.60 (− 0.68, − 0.53) % versus − 0.54 (− 0.59, − 0.49) % (p=0.568), FPG − 1.37 (− 1.53, − 1.22) mmol/l vs − 1.37 (− 1.47, − 1.27) mmol/l (p=0.627), BW when expressed in percentage of baseline BW − 2.23 (− 2.55, − 1.90) % vs − 2.16 (− 2.37, − 1.96) % (p=0.324), and SBP − 4.53 (− 5.53, − 3.53) mmHg vs − 4.06 (− 4.83, − 3.29) mmHg) (p=0.223). In conclusion, clinical efficacy of SGLT2i, as an add-on treatment to metformin monotherapy in patients with T2DM, is similar in Asian versus non-Asian patients, despite known ethnic differences in phenotype and pathophysiology of T2DM.Keywords: blood pressure, body weight, combined therapy, glucose control, HbA1c, oral antidiabetic drugScheen AJDove Medical Pressarticleblood pressurebody weightcombined therapyglucose controlhba1coral antidiabetic drugSpecialties of internal medicineRC581-951ENDiabetes, Metabolic Syndrome and Obesity: Targets and Therapy, Vol Volume 13, Pp 2765-2779 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	blood pressure body weight combined therapy glucose control hba1c oral antidiabetic drug Specialties of internal medicine RC581-951
spellingShingle	blood pressure body weight combined therapy glucose control hba1c oral antidiabetic drug Specialties of internal medicine RC581-951 Scheen AJ SGLT2 Inhibitors as Add-On Therapy to Metformin for People with Type 2 Diabetes: A Review of Placebo-Controlled Trials in Asian versus Non-Asian Patients
description	André J Scheen1,2 1Diabetes, Nutrition and Metabolic Disorders, Department of Medicine, CHU Liège, Liège University, Liège, Belgium; 2Clinical Pharmacology Unit, CHU Liège, Center for Interdisciplinary Research on Medicines (CIRM), Liège University, Liège, BelgiumCorrespondence: André J Scheen Email andre.scheen@chuliege.beAbstract: Metformin remains the first pharmacological choice for treating hyperglycemia in type 2 diabetes (T2DM) in most international guidelines. Sodium-glucose cotransporter type 2 inhibitors (SGLT2is) are increasingly used as add-on therapy. T2DM pathophysiology is different in Asian and non-Asian (mainly Caucasian) patients. The aim of this systematic review is to compare the efficacy of SGLT2is vs placebo added to metformin in randomized controlled trials (RCTs: range 12– 52 weeks) in Asian versus non-Asian patients with T2DM. The primary endpoint is the reduction in glycated hemoglobin (HbA1c) from baseline and key secondary endpoints are reductions in fasting plasma glucose (FPG), body weight (BW) and systolic blood pressure (SBP). Systematic literature search collected 7 RCTs (3 with 2 doses) in Asian patients (10 analyses, n=1164, iSGLT2: canagliflozin, dapagliflozin, ertugliflozin, ipragliflozin, tofogliflozin)) and 10 RCTs (6 with two doses) in non-Asian patients (16 analyses, n=2482, iSGLT2: canagliflozin, dapagliflozin, empagliflozin, ertugliflozin, ipragliflozin). Baseline values of HbA1c (7.98± 0.19 vs 7.89± 0.27%), FPG (8.80 ± 0.46 vs 9.11± 0.49 mmol/l) and SBP (128.4± 1.6 vs 130.2± 3.1 mmHg) were not significantly different in Asian vs non-Asian patients, but BW was lower in Asian patients (71.6± 4.8 vs 88.0± 2.5 kg, p< 0.001). The placebo-adjusted weighed mean differences (WMD, 95% CI) were similar in Asian versus non-Asian patients regarding the reductions in HbA1c − 0.60 (− 0.68, − 0.53) % versus − 0.54 (− 0.59, − 0.49) % (p=0.568), FPG − 1.37 (− 1.53, − 1.22) mmol/l vs − 1.37 (− 1.47, − 1.27) mmol/l (p=0.627), BW when expressed in percentage of baseline BW − 2.23 (− 2.55, − 1.90) % vs − 2.16 (− 2.37, − 1.96) % (p=0.324), and SBP − 4.53 (− 5.53, − 3.53) mmHg vs − 4.06 (− 4.83, − 3.29) mmHg) (p=0.223). In conclusion, clinical efficacy of SGLT2i, as an add-on treatment to metformin monotherapy in patients with T2DM, is similar in Asian versus non-Asian patients, despite known ethnic differences in phenotype and pathophysiology of T2DM.Keywords: blood pressure, body weight, combined therapy, glucose control, HbA1c, oral antidiabetic drug
format	article
author	Scheen AJ
author_facet	Scheen AJ
author_sort	Scheen AJ
title	SGLT2 Inhibitors as Add-On Therapy to Metformin for People with Type 2 Diabetes: A Review of Placebo-Controlled Trials in Asian versus Non-Asian Patients
title_short	SGLT2 Inhibitors as Add-On Therapy to Metformin for People with Type 2 Diabetes: A Review of Placebo-Controlled Trials in Asian versus Non-Asian Patients
title_full	SGLT2 Inhibitors as Add-On Therapy to Metformin for People with Type 2 Diabetes: A Review of Placebo-Controlled Trials in Asian versus Non-Asian Patients
title_fullStr	SGLT2 Inhibitors as Add-On Therapy to Metformin for People with Type 2 Diabetes: A Review of Placebo-Controlled Trials in Asian versus Non-Asian Patients
title_full_unstemmed	SGLT2 Inhibitors as Add-On Therapy to Metformin for People with Type 2 Diabetes: A Review of Placebo-Controlled Trials in Asian versus Non-Asian Patients
title_sort	sglt2 inhibitors as add-on therapy to metformin for people with type 2 diabetes: a review of placebo-controlled trials in asian versus non-asian patients
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/22b69cc7d942447788c0e405d101010e
work_keys_str_mv	AT scheenaj sglt2inhibitorsasaddontherapytometforminforpeoplewithtype2diabetesareviewofplacebocontrolledtrialsinasianversusnonasianpatients
_version_	1718401718696280064

SGLT2 Inhibitors as Add-On Therapy to Metformin for People with Type 2 Diabetes: A Review of Placebo-Controlled Trials in Asian versus Non-Asian Patients

Ejemplares similares