jdm

Journal of Diabetes & Metabolism

ISSN - 2155-6156

Abstract

The effectiveness of Sitagliptin vs ipragliflozin for type 2 diabetes

Atsuko M, Yasuo T, Yasushi T, Masaaki M, Hideaki K, Nobuo S, Mitsuo O, Masashi I, Kazuhiko H, Sachio A, Akira K, Taro A, Keiji T, Hideo M, Tetsuro T, Matsuba I*, Mizuki K, Hikaru A, Taisuke K, Shogo I, Hiroshi T, Akira K, Shinichi U, Nobuaki M, Shigeru N, Masahiko T, Masahiro T, Takashi I, Takehiro K and Kotaro I

Background: There have been direct comparisons of dipeptidyl peptidase-4 inhibitors and sodium-glucose cotransporter-2 inhibitors in Japanese patients with type 2 diabetes.

Methods: We retrospectively assessed the effects of 24-week treatment with sitagliptin (a dipeptidyl peptidase-4 inhibitor) in the ASSET-K study or 24-week treatment with ipragliflozin (a sodium-glucose cotransporter-2 inhibitor) in the ASSIGN-K study. In both studies, patients with poor glycemic control received the study drug in addition to standard care with/without other antidiabetic medications or were switched to the study drug. The effects of each drug on metabolic risk factors (body weight, blood glucose, and lipids), blood pressure, and renal function were compared.

Results: After 4 weeks of treatment, hemoglobin A1c was significantly lower in patients receiving ipragliflozin than in those receiving sitagliptin, but the difference was not significant at 12 or 24 weeks. Body mass index showed a significantly larger decrease with ipragliflozin than sitagliptin throughout most of the study period (p <0.001 at 24 weeks). A similar result was obtained for the mean blood pressure (p=0.007 at 24 weeks). In contrast, the decrease of the estimated glomerular filtration rate after 24 weeks was significantly larger in patients treated with sitagliptin than those receiving ipragliflozin (p=0.012).

Conclusions: Ipragliflozin may be more effective than sitagliptin for Japanese patients with type 2 diabetes who have hypertension, obesity, and/or renal dysfunction.

Top