Dapagliflozin, metformin XR, or both: initial pharmacotherapy for type 2 diabetes, a randomised controlled trial
International Journal of Clinical Practice,  Clinical Article

Henry RR et al. - In treatment-naïve patients with type 2 diabetes (T2D), dapagliflozin plus metformin was generally well tolerated and effective in reducing HbA1c, fasting plasma glucose (FPG) and weight. Dapagliflozin-induced glucosuria led to an increase in events suggestive of urinary tract and genital infections.

Methods
  • Eligible patients had baseline HbA1c 7.5-12%.
  • Each trial had three arms: dapagliflozin plus metformin, dapagliflozin monotherapy and metformin monotherapy.
  • Dapagliflozin in combination and as monotherapy was dosed at 5mg (Study 1) and 10 mg (Study 2).
  • Metformin in combination and as monotherapy was titrated to 2000 mg.
  • The primary endpoint was HbA1c change from baseline; secondary endpoints included change in fasting plasma glucose (FPG) and weight.

Results
  • In both trials, combination therapy led to significantly greater reductions in HbA1c compared with either monotherapy: -2.05 for dapagliflozin + metformin, -1.19 for dapagliflozin, and -1.35 for metformin (p<0.0001) (Study 1); -1.98 for dapagliflozin + metformin, -1.45 for dapagliflozin and -1.44 for metformin (p<0.0001) (Study 2).
  • Combination therapy was statistically superior to monotherapy in reduction of FPG (p<0.0001 for both studies); combination therapy was more effective than metformin for weight reduction (p<0.0001).
  • Dapagliflozin 10 mg was non-inferior to metformin in reducing HbA1c (Study 2).
  • Events suggestive of genital infection were reported in 6.7%, 6.9% and 2.0% (Study 1) and 8.5%, 12.8% and 2.4% (Study 2) of patients in combination, dapagliflozin and metformin groups; events suggestive of urinary tract infection were reported in 7.7%, 7.9% and 7.5% (Study 1) and 7.6%, 11.0% and 4.3% (Study 2) of patients in the respective groups.
  • No major hypoglycaemia was reported.

Please login or register to follow this author.
► Click here to access PubMed, Publisher and related articles...
<< Previous Article | Next Article >>

Your Unread Messages in Medical Student

See All >> Messages include industry-sponsored communications and special communications from MDLinx

Most Popular Medical Student Articles

1 Midlife dietary vitamin D intake and subsequent performance in different cognitive domains Annals of Nutrition and Metabolism, September 16, 2014    Clinical Article

2 Use of pragmatic community-based interventions to enhance recruitment and adherence in a randomized trial of Tai Chi for women with osteopenia: Insights from a qualitative substudy Menopause, November 10, 2014    Clinical Article

3 Regular fish consumption and age-related brain gray matter loss American Journal of Preventive Medicine, August 15, 2014    Clinical Article

4 Total, caffeinated and decaffeinated coffee and tea intake and gastric cancer risk: Results from the EPIC cohort study International Journal of Cancer, October 3, 2014    Clinical Article

5 Effect of black tea intake on blood cholesterol concentrations in individuals with mild hypercholesterolemia: a diet-controlled randomized trial Journal of the Academy of Nutrition and Dietetics, November 11, 2014    Clinical Article

6 Consumption of garlic and risk of colorectal cancer: An updated meta-analysis of prospective studies Full Text World Journal of Gastroenterology, November 18, 2014    Free full text    Evidence Based Medicine

7 Fiber intake and risk of subsequent prostate cancer in Japanese men American Journal of Clinical Nutrition, November 26, 2014    Clinical Article

8 Associations between the levels of sclerostin, phosphate, and fibroblast growth factor-23 and treatment with vitamin D in hemodialysis patients with low intact PTH level Osteoporosis International, November 10, 2014    Evidence Based Medicine

9 Incidence of hypercalciuria and hypercalcemia during vitamin D and calcium supplementation in older women Menopause, November 7, 2014    Clinical Article

10 Dairy products, calcium, and prostate cancer risk: A systematic review and meta-analysis of cohort studies American Journal of Clinical Nutrition, November 26, 2014    Clinical Article

11 Omega-3 supplements for patients in chemotherapy and/or radiotherapy: A systematic review Clinical Nutrition, November 21, 2014    Clinical Article

12 Fruit and vegetable intake and rate of heart failure: A population-based prospective cohort of women European Journal of Heart Failure, November 12, 2014    Clinical Article

13 Effect of low salt diet on insulin resistance in salt-sensitive versus salt-resistant hypertension Hypertension, November 26, 2014    Clinical Article

14 Systemic markers of collagen metabolism and vitamin C in smokers and non-smokers with pelvic organ prolapse European Journal of Obstetrics & Gynecology and Reproductive Biology, November 26, 2014    Clinical Article

15 High-fructose diet in adolescence may exacerbate depressive-like behavior Emory's Woodruff Health Sciences Center News, November 21, 2014

16 Association between fatty acid supplementation and prenatal stress in African Americans: A randomized controlled trial Obstetrics and Gynecology, November 26, 2014    Clinical Article

17 Vegetarian diets and glycemic control in diabetes: A systematic review and meta-analysis Full Text Cardiovascular Diagnosis and Therapy, November 20, 2014    Free full text    Evidence Based Medicine    Review Article

18 Assessment of the potential for international dissemination of Ebola virus via commercial air travel during the 2014 west African outbreak The Lancet, October 23, 2014    Evidence Based Medicine    Clinical Article

19 Association between sugar-sweetened beverages and type 2 diabetes: a meta-analysis Journal of Diabetes Investigation, November 13, 2014    Evidence Based Medicine    Review Article

20 Tomato juice consumption improves blood antioxidative biomarkers in overweight and obese females Clinical Nutrition, November 13, 2014    Clinical Article

Indexed Journals in Medical Student: Academic Medicine, BMC Medical Education, Medical Teachermore