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.
Are you sure you want to Unfollow 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 Effect of pentoxifylline on renal function and urinary albumin excretion in patients with diabetic kidney disease: The PREDIAN trial Journal of the American Society of Nephrology, June 30, 2014    Clinical Article

2 Oral bisphosphonate use and total knee/hip implant survival: Validation of results in an external population-based cohort Arthritis & Rheumatism, August 13, 2014    Clinical Article

3 Vancomycin-resistant enterococci colonization among dialysis patients: A meta-analysis of prevalence, risk factors, and significance American Journal of Kidney Diseases, July 18, 2014    Review Article

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

5 Pistachio nut consumption modifies systemic hemodynamics, increases heart rate variability, and reduces ambulatory blood pressure in well-controlled type 2 diabetes: A randomized trial Full Text Journal of the American Heart Association, September 19, 2014    Free full text

6 Old medications and new targeted therapies in systemic sclerosis Rheumatology, August 1, 2014    Review Article

7 Long-term high-dose vitamin D3 supplementation and blood pressure in healthy adults Hypertension, September 26, 2014    Clinical Article

8 A systematic review investigating interventions that can help reduce consumption of sugar-sweetened beverages in children leading to changes in body fatness Journal of Human Nutrition and Dietetics, September 26, 2014    Review Article

9 Nutrition for the prevention and treatment of chronic kidney disease in diabetes Canadian Journal of Diabetes, September 26, 2014    Review Article

10 Factors that affect efficacy of ultrasound surveillance for early stage hepatocellular carcinoma in patients with cirrhosis Clinical Gastroenterology and Hepatology , September 26, 2014    Clinical Article

11 Rationale and design of the vitamin D and type 2 diabetes (D2d) study: a diabetes prevention trial Diabetes Care, September 11, 2014    Clinical Article

12 Dietary folate and reproductive success among women undergoing assisted reproduction Obstetrics and Gynecology, September 26, 2014    Clinical Article

13 Gradual reduction of cigarette consumption as a cessation strategy: Prevalence, correlates, and relationship with quitting Nicotine & Tobacco Research, September 26, 2014    Clinical Article

14 Appropriateness of imaging for lung cancer staging in a National Cohort Journal of Clinical Oncology, September 26, 2014    Clinical Article

15 Vitamin d receptor genetic polymorphism is significantly associated with decreased risk of hypertension in a Chinese han population The Journal of Clinical Hypertension, September 26, 2014    Clinical Article

16 Cost-effectiveness analysis of an enteral nutrition protocol for children with common gastrointestinal diseases in China: good start but still a long way to go Journal of Parenteral and Enteral Nutrition, September 26, 2014    Clinical Article

17 Epidemiology of primary Sjogren's syndrome: A systematic review and meta-analysis Annals of Rheumatic Diseases, August 28, 2014    Evidence Based Medicine    Review Article

18 Crosstalk between gastrointestinal neurons and the brain in the control of food intake Best Practice & Research Clinical Endocrinology & Metabolism, September 26, 2014    Clinical Article

19 Relationship between whole-body macronutrient oxidative partitioning and pancreatic insulin secretion/β-cell function in non-diabetic humans Metabolism, September 26, 2014    Clinical Article

20 Is age a better predictor of weight loss one year after gastric bypass than symptoms of disordered eating, depression, adult ADHD and alcohol consumption? Eating Behaviours, September 26, 2014    Clinical Article

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

Register now to view all the MDLinx contents (FREE)!

  • Stay current on the latest literature, research and clinical news
  • Get special communications and offers from MDLinx and our sponsors
  • Receive invitations to paid market research
View Samples and Register

Connect with us, stay current.

Receive the latest mecial news
updates for free via email

Sign up!

Subscribe to our free RSS feeds:

Get the latest news in your specialty automatically added to your newsreader or your personal My Yahoo!, Google, My MSN or My AOL page. Learn More

Close