Dapagliflozin

2015 ◽  
Vol 29 (2) ◽  
pp. 165-171 ◽  
Author(s):  
Portia N. Davis ◽  
Uche Anadu Ndefo ◽  
Ashley Oliver
Keyword(s):  
Type 2 Diabetes ◽  
Clinical Evidence ◽  
Hypoglycemic Agents ◽  
Controlled Clinical Trials ◽  
Data Synthesis ◽  
Glucose Lowering ◽  
Medline Search ◽  
Sodium Glucose Cotransporter ◽  
Clinical Trial Results

Objective: To review clinical evidence for the efficacy, safety, and tolerability of dapagliflozin (Farxiga-AstraZeneca), a sodium glucose cotransporter 2 inhibitor, as monotherapy or in combination with other hypoglycemic agents for the treatment of type 2 diabetes. Data Sources: Literature was identified through a systematic MEDLINE search of clinical trial results for dapagliflozin. Data Synthesis: Multiple controlled clinical trials have established the efficacy, safety, and tolerability of dapagliflozin as monotherapy or in combination with other therapies for type 2 diabetes. Dapagliflozin is approved by Food and Drug Administration as monotherapy or as an add-on to other glucose lowering agents including insulin for the treatment of type 2 diabetes. Conclusion: Dapagliflozin is effective for the treatment of type 2 diabetes.

The Use of SGLT2i and GLP-1 RA in Patients with Type 2 Diabetes in Thailand: Evidence Review and Recommendations

2021 ◽  
Vol 104 (11) ◽  
pp. 1850-1865
Keyword(s):  
Type 2 Diabetes ◽  
Glucose Lowering ◽  
Sodium Glucose Cotransporter ◽  
Evidence Review ◽  
Glucagon Like Peptide ◽  
Glucagon Like Peptide 1 ◽  
Glucose Lowering Therapy ◽  
The Cost ◽  
Selection Of

Background: Cardiovascular (CV) and renal comorbidities are common among type 2 diabetes (T2D) patients, and significantly increase the cost and burden of care. Both sodium-glucose cotransporter-2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1 RA) improve key outcomes including major CV events, hospitalization for heart failure, and renal outcomes, albeit to varying degrees in different T2D populations. Materials and Methods: The authors reviewed evidence from GLP-1 RA and SGLT2i CV outcomes trials and real-world studies in Thailand and elsewhere. Results: The authors formulated recommendations to guide selection of anti-diabetes medication based on patients’ clinical characteristics and CV or renal risk profile. Conclusion: These recommendations could help guide management of CV/renal comorbidities and risk alongside glucose-lowering therapy for individual patients. Keywords: Type 2 diabetes mellitus; Cardiovascular diseases; Chronic kidney disease; Clinical outcomes; SGLT2i; GLP-1 RA

scholarly journals Pharmacoeconomic evaluation of ipragliflozin in combination with metformin in comparison with other regimens of therapy for type 2 diabetes mellitus

2021 ◽  
pp. 50-63
Author(s):  
A. S. Kolbin ◽  
A. A. Kurylev ◽  
Yu. E. Balykina ◽  
M. A. Proskurin
Keyword(s):  
Type 2 Diabetes ◽  
Cost Effectiveness ◽  
Weighted Average ◽  
Sglt2 Inhibitors ◽  
Cost Effectiveness Ratio ◽  
Glucose Lowering ◽  
Lowering Therapy ◽  
Sodium Glucose Cotransporter ◽  
Glucose Lowering Therapy

Ipragliflozin is a selective sodium-glucose cotransporter 2 (SGLT2) inhibitor that reduce plasma glucose concentrations by inhibiting glucose reabsorption by the kidney through inhibiting SGLT2 sodium-glucose cotransporter and induce glycosuria. SGLT2 inhibitors are a new class of glucose lowering drugs most recently approved for treatment of type 2 diabetes mellitus (T2DM). Unlike other antidiabetic agents, SGLT2 inhibitors improve glycemic control (by HbA1c) and provide multiple additional benefits, including decreased body weight, blood pressure, and other multiple pleiotropic effects. The completed clinical trials and real world data have provided evidence that including of SGLT2 inhibitors in the treatment of T2DM has benefits of reduction of cardiovascular and renal outcomes. Goal. The aim of the study was to conduct a clinical and economic examination of ipragliflozin in comparison with other regimens of glucose-lowering therapy with other SGLT2 inhibitors. Methods. In carrying out the pharmacoeconomic analysis itself, a cost-effectiveness analysis (CEA) was applied with the calculation of the corresponding cost-effectiveness ratio (CER), incremental cost-effectiveness ratio (ICER) according to the formula, as well as an a «budget impact analysis». Multiple one-way sensitivity analysis, check the robustness of the results of the main scenario results to changes in key parameters such as the cost of drugs and complications of diabetes. The time horizon for analyzing the dynamics of economic consequences when using ipragliflozin as a glucose-lowering therapy for T2DM was 5 years. Results. The weighted average cost per patient per year when using the ipragliflozin treatment strategy is 31,182 rubles. The costs of the empagliflozin strategy are 61,291 rubles per patient. In the case of using dapagliflozin, the weighted average costs are 30,032 rubles per patient per year, the total direct medical costs for the current drug therapy option, calculated on the initial number of target practice in 72,143 patients with type 2 diabetes, amounted to 3,068,642,442 rubles. Analysis of the trend of changes in weighted average costs showed that the broader use of ipragliflozin for the treatment of T2DM in the target population leads to reducing in diabetes related direct medical costs by 6.7 %, while the total economic effect of ipragliflozin introduction over five years will be 501,539,327 rubles. Conclusions. Use of ipragliflozin + metformin in T2DM treatment is a cost-effective strategy compared to empagliflozin + metformin. The combination of ipragliflozin with metformin versus dapagliflozin + metformin is economically feasible in terms of cost-effectiveness.

scholarly journals Incorporating SGLT2i and GLP-1RA for Cardiovascular and Kidney Disease Risk Reduction: Call for Action to the Cardiology Community

Circulation ◽  
2021 ◽  
Vol 144 (1) ◽  
pp. 74-84
Author(s):  
Adam J. Nelson ◽  
Neha J. Pagidipati ◽  
Vanita R. Aroda ◽  
Matthew A. Cavender ◽  
Jennifer B. Green ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Kidney Disease ◽  
Disease Risk ◽  
Primary Care Providers ◽  
Care Providers ◽  
Glucose Lowering ◽  
Sodium Glucose Cotransporter ◽  
Glucagon Like Peptide 1 ◽  
Risk Reducing

Multiple sodium glucose cotransporter-2 inhibitors (SGLT-2i) and glucagon-like peptide-1 receptor agonists (GLP-1RA) have been shown to impart significant cardiovascular and kidney benefits, but are underused in clinical practice. Both SGLT-2i and GLP-1RA were first studied as glucose-lowering drugs, which may have impeded uptake by cardiologists in the wake of proven cardiovascular efficacy. Their significant effect on cardiovascular and kidney outcomes, which are largely independent of glucose-lowering effects, must drive a broader use of these drugs. Cardiologists are 3 times more likely than endocrinologists to see patients with both type 2 diabetes and cardiovascular disease, thus they are ideally positioned to share responsibility for SGLT-2i and GLP-1RA treatment with primary care providers. In order to increase adoption, SGLT-2i and GLP-1RA must be reframed as primarily cardiovascular and kidney disease risk-reducing agents with a side effect of glucose-lowering. Coordinated and multifaceted interventions engaging clinicians, patients, payers, professional societies, and health systems must be implemented to incentivize the adoption of these medications as part of routine cardiovascular and kidney care. Greater use of SGLT-2i and GLP-1RA will improve outcomes for patients with type 2 diabetes at high risk for cardiovascular and kidney disease.

scholarly journals Eligibility of patients with type 2 diabetes for sodium–glucose cotransporter 2 inhibitor cardiovascular outcomes trials: a global perspective from the DISCOVER study

2019 ◽  
Vol 7 (1) ◽  
pp. e000627 ◽  
Author(s):  
Stéphane Pintat ◽  
Peter Fenici ◽  
Niklas Hammar ◽  
Linong Ji ◽  
Kamlesh Khunti ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Cardiovascular Outcomes ◽  
Second Line ◽  
Glucose Lowering ◽  
Lowering Therapy ◽  
Sodium Glucose Cotransporter ◽  
The Mean ◽  
Glucose Lowering Therapy

ObjectiveTo assess the eligibility of patients participating in DISCOVER (a 3-year, prospective, observational study program of 15 992 patients with type 2 diabetes [T2D] initiating a second-line glucose-lowering therapy across 38 countries) for four cardiovascular outcomes trials (CVOTs) of sodium–glucose cotransporter 2 inhibitors (CANagliflozin cardioVascular Assessment Study [CANVAS], Dapagliflozin effect on CardiovascuLAR Events trial [DECLARE-TIMI 58], EMPAgliflozin cardiovascular OUTCOME event trial [EMPA-REG OUTCOME], and eValuation of ERTugliflozin effIcacy and Safety CardioVascular outcomes trial [VERTIS-CV]).Research design and methodsIn this cross-sectional analysis, baseline characteristics of DISCOVER patients were compared with the inclusion and exclusion criteria of the CVOTs to assess patient eligibility, overall and in four regions (Asia-Pacific, Europe, Latin America, and Middle East and Africa).ResultsOverall, 11 385 patients (71.2%) had sufficient data for the analysis; 56.1% were men. The mean age and time since T2D diagnosis were 57.4 and 5.6 years, respectively. The mean glycated hemoglobin level was 8.3%. DISCOVER patients were younger, and fewer had a history of cardiovascular disease, than those enrolled in the CVOTs. Eligibility varied across the CVOTs; the proportion of eligible DISCOVER patients was highest for DECLARE-TIMI 58 (40.5%), followed by CANVAS (19.9%), VERTIS-CV (7.2%), and EMPA-REG OUTCOME (7.1%); 54.6% of patients were not eligible for any CVOT. Eligibility for each CVOT varied across regions, which was explained by the differing proportions of patients with established cardiovascular disease.ConclusionsIn a large, international population of patients with T2D initiating a second-line glucose-lowering therapy, DECLARE-TIMI 58 was the most inclusive CVOT, suggesting that its study population will be more representative of patients encountered in routine clinical practice than those of CANVAS, EMPA-REG OUTCOME, and VERTIS-CV.

scholarly journals Relationship of clinical efficacy of glucose lowering agents, gut microbiota, diet, and patient’s genotype in diabetes mellitus type 2

2018 ◽  
Vol 16 (4) ◽  
pp. 11-18
Author(s):  
Aleksandr L. Urakov ◽  
Konstantin G. Gurevich ◽  
Iuliia A. Sorokina ◽  
Liubov V. Lovtsova ◽  
Olga V. Zanozina ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Diabetes Mellitus Type 2 ◽  
Intestinal Microflora ◽  
Hypoglycemic Agents ◽  
Glucose Lowering ◽  
Lowering Therapy ◽  
Glucose Lowering Therapy ◽  
Relationship Of

The review is devoted to revealing the connection between the intestinal microflora, diet and the effectiveness of glucose – lowering therapy in patients with type 2 diabetes. Potential targets and the effects of oral and injectable hypoglycemic agents on microbiota in this category of patients are considered. The work reflects modern views on hypoglycemic drugs from the standpoint of the science of metabolomics within the framework of personalized medicine.

scholarly journals Semaglutide (Rybelsus)

2021 ◽  
Vol 1 (6) ◽  
Author(s):  
Reimbursement Team
Keyword(s):  
Type 2 Diabetes ◽  
Treatment Cost ◽  
Clinical Evidence ◽  
Dipeptidyl Peptidase 4 ◽  
Sodium Glucose Cotransporter ◽  
Dipeptidyl Peptidase 4 Inhibitors ◽  
Glucagon Like Peptide ◽  
Glucagon Like Peptide 1 ◽  
High Treatment

Clinical evidence suggests that Rybelsus should be reimbursed to treat type 2 diabetes in adults if it is used in addition to metformin or other antihyperglycemic agents and does not cost more than glucagon-like peptide-1 receptor agonists, dipeptidyl peptidase-4 inhibitors, and sodium-glucose cotransporter-2 inhibitors. Rybelsus is more costly than most similar diabetes treatments. Rybelsus is expected to increase budgets by more than $38 million over 3 years. To account for the high treatment cost, the price of Rybelsus should be reduced. If Rybelsus is not reimbursed as an add-on treatment for patients with type 2 diabetes, there are several other alternative treatments available for these patients.

scholarly journals Inadequate Triglyceride Management Worsens the Durability of Dipeptidyl Peptidase-4 Inhibitor in Subjects with Type 2 Diabetes Mellitus

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Masashi Shimoda ◽  
Maiko Miyoshi-Takai ◽  
Shintaro Irie ◽  
Akihito Tanabe ◽  
Atsushi Obata ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Dipeptidyl Peptidase ◽  
Hypoglycemic Agents ◽  
Baseline Hba1c ◽  
Glucose Lowering ◽  
Dipeptidyl Peptidase 4 ◽  
Lowering Effect ◽  
Glucose Lowering Effect ◽  
Effective Group

Dipeptidyl peptidase-4 (DPP-4) inhibitors are often used all over the world and exert various beneficial effects including glucose-lowering effect in many subjects with type 2 diabetes. It is poorly understood, however, which factors are closely related with the durability of glucose-lowering effect by DPP-4 inhibitor. In this study, we examined retrospectively which factors could mainly influence the durability of DPP-4 inhibitor. We enrolled 212 participants with type 2 diabetes to whom DPP-4 inhibitor was administered for over 1 year without an addition or increase of other hypoglycemic agents. Age and baseline HbA1c level were significantly higher in the effective group than those in the ineffective group. The effective group had a tendency of smaller amounts of weight change, average total cholesterol, and average triglyceride compared with the ineffective group. Multiple logistic regression analysis showed that average triglyceride and baseline HbA1c were independent predictors associated with the durability of DPP-4 inhibitor. Moreover, an average triglyceride level contributed to the durability of DPP-4 inhibitor in the obese group (BMI ≥ 25 kg/m2) but not in the nonobese group (BMI < 25 kg/m2). These results suggest the importance of strict triglyceride management to maintain the durability of glucose-lowering effect by DPP-4 inhibitor, especially in obese subjects with type 2 diabetes.

Orlistat Use in Type 2 Diabetes

2002 ◽  
Vol 36 (7-8) ◽  
pp. 1210-1218 ◽  
Author(s):  
Laura J Snider ◽  
Margaret Malone
Keyword(s):  
Type 2 Diabetes ◽  
English Language ◽  
Data Extraction ◽  
Double Blind ◽  
Data Synthesis ◽  
Specific Data ◽  
Medline Search ◽  
Treatment Of Obesity ◽  
Key Terms

OBJECTIVE: To review the use of orlistat in type 2 diabetes. DATA SOURCES: A MEDLINE search of the English-language literature (1990–August 2001) was performed using the key terms orlistat, obesity, glucose, and diabetes. DATA EXTRACTION: All articles pertaining to orlistat were considered for inclusion, with emphasis placed on randomized, placebo-controlled, double-blind clinical trials. DATA SYNTHESIS: In April 1999, orlistat was approved by the Food and Drug Administration for the treatment of obesity. Of 13 randomized, placebo-controlled studies, only 2 reported specific data in individuals with type 2 diabetes. Both reported significant weight reduction and improved glycemic control over placebo. CONCLUSIONS: Since weight loss is a difficult goal to achieve in patients with type 2 diabetes, orlistat can be a safe, effective addition to a multidisciplinary approach.

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