Network meta-analysis of responses to DPP-4 and SGLT2 inhibitors: What next after metformin with a baseline HbA1c ≤8%?
Abstract
Network meta-analysis of responses to DPP-4 and SGLT 2 inhibitors: What next after metformin with a baseline HbA1c u22648%?W.D. Strain1, M.C. Thomas2, J.E. Foley 3, P.M. Paldu00e1nius41University of Exeter Medical School, Exeter, UK2Baker IDI Heart and Diabetes Institute, Melbourne, Australia3Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA4Novartis Pharma AG, Basel, SwitzerlandBackground: Treatment decisions for timely delivery of care for optimised management of type 2 diabetes mellitus (T2DM) should be supported by evidence-based data and guidelines, which are tailored to individual patient preferences, projected long-term plans and presence or anticipated future risk of comorbidities. Guidelines indicate early and more aggressive intensification of failing metformin monotherapy for prevention of hyperglycaemia-driven complications of T2DM especially in younger patients with shorter duration of T2DM. Dipeptidyl peptidase-4 inhibitors (DPP4i) and sodium-glucose co-transporter 2 inhibitors (SGLT2i) lower glucose levels in patients with T2DM proportional to the baseline HbA1c albeit with different mechanisms of action. This relationship, in those with normal renal function at least, appears to be steeper with SGLT2i, with greater glycosuria and efficacy in patients with sustained high HbA1c levels, but attenuating efficacy closer to target levels for glycaemic control. Aim: To explore the relative benefits of DPP4i and SGLT2i in people inadequately controlled with…
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