Dapagliflozin

Type 2 diabetes

Endocrinology

Urology

Empagliflozin

Internal medicine

Pharmacology

Glimepiride

Medicine

Metformin

Diabetes mellitus

Diabetes Research and Clinical Practice

<h2>Abstract</h2><h3>Aims</h3> To directly compare the effectiveness and safety between two distinct sodium-glucose co-transporter 2 (SGLT2) inhibitors, empagliflozin and dapagliflozin, as part of a quadruple oral antidiabetic agents (OADs) in patients with inadequately controlled type 2 diabetes (T2D). <h3>Methods</h3> This study was an open-labeled, prospective, 52-week study conducted in T2D patients with glycated hemoglobin (HbA<sub>1c</sub>) ranging 7.5–12.0% with metformin, glimepiride and dipeptidyl peptidase-4 inhibitors. Patients were divided into either empagliflozin (25 mg/day) or dapagliflozin (10 mg/day). The outcome measures included changes in HbA<sub>1c</sub>, fasting plasma glucose (FPG), and cardiometabolic variables and the safety profiles. <h3>Results</h3> In total, 350 patients were enrolled with empagliflozin (n = 176) and dapagliflozin (n = 174), respectively. After 52 weeks, both groups showed significant reductions in HbA<sub>1c</sub> and FPG, but the reduction was greater in the empagliflozin group (P < 0.001). Both groups showed significantly decreased blood pressure and body weight and high-density lipoprotein cholesterol levels were increased in the empagliflozin (between groups, P = 0.035). Both groups showed similar safety profiles. <h3>Conclusions</h3> Our study demonstrated that SGLT2 inhibitors can be effectively used as a fourth OAD in T2D patients who are treated with three other OADs. More specifically, empagliflozin was more effective in reducing HbA<sub>1c</sub> and improving other cardiometabolic parameters than dapagliflozin. <b>Clinical Trial Number</b> NCT03748810 (ClinicalTrials.gov).

Empagliflozin versus dapagliflozin in patients with type 2 diabetes inadequately controlled with metformin, glimepiride and dipeptidyl peptide 4 inhibitors: A 52-week prospective observational study