Effects of exenatide once weekly plus dapagliflozin, exenatide once weekly, or dapagliflozin, added to metformin monotherapy, on body weight, systolic blood pressure, and triglycerides in patients with type 2 diabetes in the DURATION-8 study

Abstract

This post hoc analysis assessed the effects on cardiovascular risk factors of body weight, systolic blood pressure (SBP) and triglycerides after 28 weeks' treatment with exenatide once weekly plus dapagliflozin, as compared with exenatide once weekly or dapagliflozin, in patient subpopulations from the DURATION-8 trial of patients with type 2 diabetes mellitus (T2DM) inadequately controlled with metformin alone. Subgroups of patients were stratified according to their baseline body weight, SBP and triglyceride levels. Body weight, SBP and triglyceride levels were reduced across most respective subgroups, with no significant subgroup-by-treatment interactions. For each treatment, weight loss was numerically greater as baseline body mass index increased. SBP reductions were greater among patients with SBP ≥140 vs <140 mm Hg for exenatide once weekly plus dapagliflozin and exenatide once weekly. Reductions in triglyceride levels were greater among patients with baseline triglycerides <1.69 vs ≥1.69 mmol/L for each treatment. The combination of exenatide once weekly plus dapagliflozin reduced cardiovascular risk factors across baseline subgroups for each variable to a greater extent than did either individual drug; the greatest effects were observed in the high baseline subgroups for body weight and SBP.

Keywords: GLP-1 analogue; SGLT2 inhibitor; dapagliflozin; exenatide; type 2 diabetes.

Figure 1

A, Changes in body weight by treatment in baseline body mass index (BMI) subgroups (<25 kg/m²; ≥25 to <30 kg/m²; and ≥30 kg/m²)^* at week 28. B, Changes in systolic blood pressure (SBP) by treatment in baseline SBP subgroups (<140 vs ≥140 mm Hg) at week 28. C, Changes in triglycerides (TGs) by treatment in baseline TG subgroups (<1.69 vs ≥1.69 mmol/L) at week 28. To convert mmol/L to mg/dL for TGs, multiply by 88.5. Changes from baseline are summarized as the least‐squares mean (LSM) ± SE in the intention‐to‐treat population. ^*There were too few patients with BMI <25 kg/m² for reliable conclusions to be drawn for this subgroup. DAPA, dapagliflozin; ExQW, exenatide once weekly; PBO, placebo