Empagliflozin versus Sitagliptin as add-on dual therapy in Egyptian patients with type 2 diabetes inadequately controlled with Metformin: a 12-week randomized, open-label, parallel-group trial

Abstract Background Diabetes is one of the world’s most widespread conditions, and diabetic patients are among the most likely to engage in fierce battles with this chronic disease. Which group should be added-on as a dual therapy for Egyptian patients with type 2 diabetes and inadequate glycemic ma...

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Main Authors: Haitham G. Zakaraia, Heba F. Salem, Mostafa A. A. Mostafa, Ahmed M. Ali, Hoda M. Rabea
Format: Article
Language:English
Published: SpringerOpen 2023-11-01
Series:Beni-Suef University Journal of Basic and Applied Sciences
Subjects:
Online Access:https://doi.org/10.1186/s43088-023-00442-0
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author Haitham G. Zakaraia
Heba F. Salem
Mostafa A. A. Mostafa
Ahmed M. Ali
Hoda M. Rabea
author_facet Haitham G. Zakaraia
Heba F. Salem
Mostafa A. A. Mostafa
Ahmed M. Ali
Hoda M. Rabea
author_sort Haitham G. Zakaraia
collection DOAJ
description Abstract Background Diabetes is one of the world’s most widespread conditions, and diabetic patients are among the most likely to engage in fierce battles with this chronic disease. Which group should be added-on as a dual therapy for Egyptian patients with type 2 diabetes and inadequate glycemic management, HbA1c ≥ 7.0% and ≤ 10% (≥ 53 and ≤ 86 mmol/mol), following not less than 3 months of metformin and diet therapy, is still up for debate. Based on this ambiguity, we designed our study to compare the safety and efficacy of sitagliptin 50 mg (n = 85) with empagliflozin 12.5 mg (n = 85) twice daily as an adjunctive therapy to metformin and diet for a further 12 weeks. HbA1c after 12 weeks of open-label therapy was the major outcome measure. Results After 12 weeks of treatment, empagliflozin drastically lowered HbA1c, FPG, PP, body weight, and triglycerides from baseline while significantly increasing LDL, total cholesterol, and HDL. On the other hand, sitagliptin significantly reduced FPG, PP (with a no discernable alteration in HbA1c), body weight, and triglycerides while significantly increasing HDL (P ≤ 0.001 for all comparisons). Comparing the two groups, empagliflozin significantly reduced HbA1c, FPG, and PP while significantly increasing LDL and triglycerides than sitagliptin (P < 0.001 for all except FPG, P = 0.005). More patients receiving empagliflozin 12.5 mg than sitagliptin 50 mg twice daily reported adverse events during open-label treatment (11.8% vs. 8.2%, respectively). Conclusions In type 2 diabetic Egyptian patients uncontrolled with metformin and diet, empagliflozin was superior to sitagliptin as regards glycemic control, weight, and SBP/DBP reduction.
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spelling doaj.art-5b84925121824d77b57be90c5e4fd2c22024-03-31T11:28:47ZengSpringerOpenBeni-Suef University Journal of Basic and Applied Sciences2314-85432023-11-011211810.1186/s43088-023-00442-0Empagliflozin versus Sitagliptin as add-on dual therapy in Egyptian patients with type 2 diabetes inadequately controlled with Metformin: a 12-week randomized, open-label, parallel-group trialHaitham G. Zakaraia0Heba F. Salem1Mostafa A. A. Mostafa2Ahmed M. Ali3Hoda M. Rabea4Clinical Pharmacy Department, Faculty of Pharmacy, University of Sadat CityPharmaceutics and Industrial Pharmacy Department, Faculty of Pharmacy, Beni-Suef UniversityInternal Medicine Department, Faculty of Medicine, October 6 UniversityClinical Pharmacy Department, Faculty of Pharmacy, October 6 UniversityClinical Pharmacy Department, Faculty of Pharmacy, Beni-Suef UniversityAbstract Background Diabetes is one of the world’s most widespread conditions, and diabetic patients are among the most likely to engage in fierce battles with this chronic disease. Which group should be added-on as a dual therapy for Egyptian patients with type 2 diabetes and inadequate glycemic management, HbA1c ≥ 7.0% and ≤ 10% (≥ 53 and ≤ 86 mmol/mol), following not less than 3 months of metformin and diet therapy, is still up for debate. Based on this ambiguity, we designed our study to compare the safety and efficacy of sitagliptin 50 mg (n = 85) with empagliflozin 12.5 mg (n = 85) twice daily as an adjunctive therapy to metformin and diet for a further 12 weeks. HbA1c after 12 weeks of open-label therapy was the major outcome measure. Results After 12 weeks of treatment, empagliflozin drastically lowered HbA1c, FPG, PP, body weight, and triglycerides from baseline while significantly increasing LDL, total cholesterol, and HDL. On the other hand, sitagliptin significantly reduced FPG, PP (with a no discernable alteration in HbA1c), body weight, and triglycerides while significantly increasing HDL (P ≤ 0.001 for all comparisons). Comparing the two groups, empagliflozin significantly reduced HbA1c, FPG, and PP while significantly increasing LDL and triglycerides than sitagliptin (P < 0.001 for all except FPG, P = 0.005). More patients receiving empagliflozin 12.5 mg than sitagliptin 50 mg twice daily reported adverse events during open-label treatment (11.8% vs. 8.2%, respectively). Conclusions In type 2 diabetic Egyptian patients uncontrolled with metformin and diet, empagliflozin was superior to sitagliptin as regards glycemic control, weight, and SBP/DBP reduction.https://doi.org/10.1186/s43088-023-00442-0T2DMSitagliptinEmpagliflozinDual therapy
spellingShingle Haitham G. Zakaraia
Heba F. Salem
Mostafa A. A. Mostafa
Ahmed M. Ali
Hoda M. Rabea
Empagliflozin versus Sitagliptin as add-on dual therapy in Egyptian patients with type 2 diabetes inadequately controlled with Metformin: a 12-week randomized, open-label, parallel-group trial
Beni-Suef University Journal of Basic and Applied Sciences
T2DM
Sitagliptin
Empagliflozin
Dual therapy
title Empagliflozin versus Sitagliptin as add-on dual therapy in Egyptian patients with type 2 diabetes inadequately controlled with Metformin: a 12-week randomized, open-label, parallel-group trial
title_full Empagliflozin versus Sitagliptin as add-on dual therapy in Egyptian patients with type 2 diabetes inadequately controlled with Metformin: a 12-week randomized, open-label, parallel-group trial
title_fullStr Empagliflozin versus Sitagliptin as add-on dual therapy in Egyptian patients with type 2 diabetes inadequately controlled with Metformin: a 12-week randomized, open-label, parallel-group trial
title_full_unstemmed Empagliflozin versus Sitagliptin as add-on dual therapy in Egyptian patients with type 2 diabetes inadequately controlled with Metformin: a 12-week randomized, open-label, parallel-group trial
title_short Empagliflozin versus Sitagliptin as add-on dual therapy in Egyptian patients with type 2 diabetes inadequately controlled with Metformin: a 12-week randomized, open-label, parallel-group trial
title_sort empagliflozin versus sitagliptin as add on dual therapy in egyptian patients with type 2 diabetes inadequately controlled with metformin a 12 week randomized open label parallel group trial
topic T2DM
Sitagliptin
Empagliflozin
Dual therapy
url https://doi.org/10.1186/s43088-023-00442-0
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