Dapagliflozin efficacy as an add-on therapy in double and triple-drug regimens: A meta-analysis of randomized control trial

A meta-analysis of randomized control trial

Abstract

Background: Diabetes is one of the most common diseases compared to others. There are many drugs available in the market to treat diabetes. Still, most of them have adverse drug reactions like hypoglycemia, weight gain, and subtherapeutic drug concentrations. SGLT-2 inhibitors are a new class of drugs used as add-on therapy to treat type-2 Diabetes Mellitus. They act by inhibiting glucose reabsorption and increasing glucose excretion via the kidneys. In an average adult, two kidneys filter about 180g of glucose per day. About 98% of the glucose filtered in the kidneys get reabsorbed in the proximal convoluted tubule back into the bloodstream, which can be inhibited by SGLT-2 inhibitors.


Method:  A systematic review and meta-analysis were performed on randomized clinical trial data, extracted from PubMed, Cochrane and Embase. All data, including baseline and shift of baseline, standard deviation, and number of participants, were recorded for HbA1c, Fasting blood glucose (FBG), Bodyweight and SBP/DBP.


Results: Twelve randomized clinical trials, including 8000 participants, were compared and divided into three groups of drugs: SAXA+DAPA+MET, SAXA+MET and DAPA+MET. The comparison is done for HbA1c (WMD:-6.78; 95% CI:-8.28; P <0.00001) (WMD:-4.88; 95% CI:-6.93; P <0.00001), FBG (SMD: -6.50; 95% CI: -8.55, -4.45; P <0.00001) (SMD: -7.75; 95% CI: -8.84, -6.66; P<0.00005,), body weight (SMD: 0.30; 95% CI: 0.27, 0.33; P =1.00) (SMD: -1.00; 95% CI: -1.90, -0.10; P<0.00001). Conclusion: Dapagliflozin, when given in combination, shows a major improvement in HbA1c and FBG levels and does not affect body weight. It was shown to be more effective when given in triple combination therapy.


Keywords: Dapagliflozine, meta-analysis, Sexagliptine, Metformin, Type two diabetes mellitus (T2DM), Sodium-glucose Cotransporter-2 (SGLT2)

Keywords: Dapagliflozine, meta-analysis, Sexagliptine, Metformin, Type two diabetes mellitus (T2DM), odium-glucose Cotransporter-2 (SGLT2)

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Author Biographies

Deepjyoti. Saikia, Dept of Pharmacy Practice, KLE College of Pharmacy Hubballi, India

Dept of Pharmacy Practice, KLE College of Pharmacy Hubballi, India

Akash Chathamvelli, Dept of Pharmacy Practice, KLE College of Pharmacy Hubballi, India

Dept of Pharmacy Practice, KLE College of Pharmacy Hubballi, India

Lizanne Fernandes, Dept of Pharmacy Practice, KLE College of Pharmacy Hubballi, India

Dept of Pharmacy Practice, KLE College of Pharmacy Hubballi, India

Kadambari Patil, Dept of Pharmacy Practice, KLE College of Pharmacy Hubballi, India

Dept of Pharmacy Practice, KLE College of Pharmacy Hubballi, India

A Aswathi, Dept of Pharmacy Practice, KLE College of Pharmacy Hubballi, India

Dept of Pharmacy Practice, KLE College of Pharmacy Hubballi, India

Pooja Mahajan, Dept of Pharmacy Practice, KLE College of Pharmacy Hubballi, India

Dept of Pharmacy Practice, KLE College of Pharmacy Hubballi, India

Sanatkumar Nyamagoud, Dept of Pharmacy Practice, KLE College of Pharmacy Hubballi, India

Dept of Pharmacy Practice, KLE College of Pharmacy Hubballi, India

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Saikia D, Chathamvelli A, Fernandes L, Patil K, Aswathi A, Mahajan P, Nyamagoud S. Dapagliflozin efficacy as an add-on therapy in double and triple-drug regimens: A meta-analysis of randomized control trial. JDDT [Internet]. 15Jan.2023 [cited 27Jan.2023];13(1):76-3. Available from: https://jddtonline.info/index.php/jddt/article/view/5863