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. 2020 Oct;11(10):2419-2428.
doi: 10.1007/s13300-020-00907-w. Epub 2020 Aug 27.

Efficacy and Safety of Sitagliptin Compared with Dapagliflozin in People ≥ 65 Years Old with Type 2 Diabetes and Mild Renal Insufficiency

Annaswamy Raji  1 , Zhi Jin Xu  2 , Raymond L H Lam  2 , Edward A O'Neill  2 , Keith D Kaufman  2 , Samuel S Engel  2
Affiliations

Efficacy and Safety of Sitagliptin Compared with Dapagliflozin in People ≥ 65 Years Old with Type 2 Diabetes and Mild Renal Insufficiency

Annaswamy Raji et al. Diabetes Ther. 2020 Oct.

Abstract

Introduction: Older patients with type 2 diabetes (T2D) are at increased risk of diabetic nephropathy and mild renal insufficiency. This analysis compared the anti-hyperglycemic efficacy and safety of sitagliptin with dapagliflozin in patients ≥ 65 years of age with T2D and mild renal insufficiency.

Methods: This was a post hoc analysis of data from 410 patients ≥ 65 years old who participated in a 24-week, randomized, double-blind clinical trial (CompoSIT-R [comparison of sitagliptin with dapagliflozin in mild renal impairment]; NCT02532855) in T2D patients with mild renal insufficiency and on metformin ± a sulfonylurea; the primary efficacy end point was change in HbA1c at week 24.

Results: Treatment groups were well balanced at baseline (mean HbA1c = 7.7/7.7% and eGFR = 79/76 ml/min/1.73 m2 for sitagliptin/dapagliflozin). At week 24, LS mean (95% CI) change in HbA1c and percentage of patients with HbA1c < 7% were greater with sitagliptin, - 0.48% and 41%, respectively, compared with dapagliflozin, - 0.36% and 28%; between-group differences = - 0.12% (- 0.36, 0.01) and 12.8% (3.3, 22.2) for change in HbA1c and percentage with HbA1c < 7%, respectively. The sitagliptin group had greater reductions in PPG end points, while the dapagliflozin group had greater reductions in FPG. Treatments were generally well tolerated. There were fewer drug-related adverse events (AEs) with sitagliptin than with dapagliflozin but AE profiles were otherwise similar.

Conclusions: In patients ≥ 65 years of age with T2D and mild renal insufficiency with inadequate glycemic control on metformin ± sulfonylurea, treatment with sitagliptin for 24 weeks resulted in improvement in HbA1c relative to treatment with dapagliflozin that is consistent with that previously observed in the overall population. Both treatments were generally well tolerated.

Keywords: DPP-4; Elderly; Incretins; SGLT2.

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Figures

Fig. 1
Fig. 1
Percentage of patients at goal of HbA1c < 7% at week 24, estimated from the LDA model described in Methods using standard multiple imputation techniques
See this image and copyright information in PMC

References

    1. International Diabetes Federation Diabetes Atlas, 9th edn. Brussels, Belgium: International Diabetes Federation. 2019.
    1. Abaterusso C, Lupo A, Ortalda V, De Biase V, Pani A, Muggeo M, et al. Treating elderly people with diabetes and stages 3 and 4 chronic kidney disease. Clin J Am Soc Nephrol. 2008;3(4):1185–1194. doi: 10.2215/CJN.00410108. - DOI - PubMed
    1. Kirkman MS, Briscoe VJ, Clark N, Florez H, Haas LB, Halter JB, et al. Diabetes in older adults. Diabetes Care. 2012;35(12):2650–2664. doi: 10.2337/dc12-1801. - DOI - PMC - PubMed
    1. Sinclair A, Bode B, Harris S, Vijapurkar U, Mayer C, Fung A, et al. Efficacy and safety of canagliflozin compared with placebo in older patients with type 2 diabetes mellitus: a pooled analysis of clinical studies. BMC Endocr Disord. 2014;14:37. doi: 10.1186/1472-6823-14-37. - DOI - PMC - PubMed
    1. Bailey RA, Wang Y, Zhu V, Rupnow MF. Chronic kidney disease in US adults with type 2 diabetes: an updated national estimate of prevalence based on Kidney Disease: improving Global Outcomes (KDIGO) staging. BMC Res Notes. 2014;7:415. doi: 10.1186/1756-0500-7-415. - DOI - PMC - PubMed