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Review

An update on the safety and efficacy of oral antidiabetic drugs: DPP-4 inhibitors and SGLT-2 inhibitors

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Pages 691-701 | Received 12 Feb 2019, Accepted 30 May 2019, Published online: 07 Jun 2019

References

  • American Diabetes Association. Pharmacologic approaches to glycemic treatment: standards of medical care in diabetes-2018. Diabetes Care. 2018 Jan;41(Suppl 1):S73–85.
  • Davies MJ, D’Alessio DA, Fradkin J, et al. Management of hyperglycaemia in type 2 diabetes, 2018. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetologia. 2018 Dec;61(12):2461–2498.
  • Haneda M, Noda M, Origasa H, et al. Japanese Clinical Practice Guideline for Diabetes 2016. J Diabetes Investig. 2018 May;9(3):657–697.
  • Kalra S, Bahendeka S, Sahay R, et al. Consensus recommendations on sulfonylurea and sulfonylurea combinations in the management of type 2 diabetes mellitus - international task force. Indian J Endocrinol Metab. 2018;22(1):132–157.
  • Weng J, Soegondo S, Schnell O, et al. Efficacy of acarbose in different geographical regions of the world: analysis of a real-life database. Diabetes Metab Res Rev. 2015 Feb;31(2):155–167.
  • Shera AS, Basit A, Team P. Pakistan’s Recommendations for Optimal Management of diabetes from Primary to Tertiary care level (PROMPT). Pak J Med Sci. 2017;33(5):1279–1283.
  • Witticke D, Seidling HM, Klimm H-D, et al. Do we prescribe what patients prefer? Pilot study to assess patient preferences for medication regimen characteristics. Patient Prefer Adherence. 2012;6:679–684.
  • Rozenfeld Y, Hunt JS, Plauschinat C, et al. Oral antidiabetic medication adherence and glycemic control in managed care. Am J Manag Care. 2008 Feb;14(2):71–75.
  • Stein SA, Lamos EM, Davis SN. A review of the efficacy and safety of oral antidiabetic drugs. Expert Opin Drug Saf. 2013 Mar;12(2):153–175.
  • Esposito K, Chiodini P, Maiorino MI, et al. A nomogram to estimate the HbA1c response to different DPP-4 inhibitors in type 2 diabetes: a systematic review and meta-analysis of 98 trials with 24 163 patients. BMJ Open. 2015 Feb;5(2):e005892.
  • Boehringer Ingelheim. Jardiance Prescribing Information (Package Insert) [Internet]. 2018 [cited 2018 Feb 8]. Available from: https://docs.boehringer-ingelheim.com/Prescribing Information/PIs/Jardiance/jardiance.pdf
  • Janssen Pharmaceutical Companies of Johnson & Johnson T Invokana Prescribing Information (Package Insert) [Internet]. 2018 [cited 2019 Feb 8]. Available from: http://www.janssenlabels.com/package-insert/product-monograph/prescribing-information/INVOKANA-pi.pdf
  • AstraZeneca. Farxiga Prescribing Information (Package Insert) [Internet]. 2014 [cited 2019 Feb 8]. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/202293s003lbl.pdf
  • Merck Pharmaceutical. Jardiance Prescribing Information (Package Insert) [Internet]. 2019 [cited 2019 Feb 8]. Available from: https://www.merck.com/product/usa/pi_circulars/j/januvia/januvia_pi.pdf
  • AstraZeneca. Onglyza Prescribing Information (Package Insert) [Internet]. 2017 [cited 2019 Feb 8]. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/022350s018lbl.pdf
  • Boehringer Ingelheim. Tradjenta Prescribing Information (Package Insert) [Internet]. 2012 [cited 2019 Feb 8]. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/201280s005lbl.pdf
  • Scirica BM, Bhatt DL, Braunwald E, et al. Saxagliptin and cardiovascular outcomes in patients with type 2 diabetes mellitus. N Engl J Med. 2013 Oct;369(14):1317–1326.
  • Green JB, Bethel MA, Armstrong PW, et al. Effect of sitagliptin on cardiovascular outcomes in Type 2 diabetes. N Engl J Med. 2015 Jul;373(3):232–242.
  • White WB, Pratley R, Fleck P, et al. Cardiovascular safety of the dipetidyl peptidase-4 inhibitor alogliptin in type 2 diabetes mellitus. Diabetes Obes Metab. 2013 Jul;15(7):668–673.
  • Rosenstock J, Perkovic V, Johansen OE, et al. Effect of linagliptin vs placebo on major cardiovascular events in adults with Type 2 diabetes and high cardiovascular and renal risk: the CARMELINA randomized clinical trial. JAMA. 2019 Jan 1;321(1):69–79.
  • White WB, Cannon CP, Heller SR, et al. Alogliptin after acute coronary syndrome in patients with type 2 diabetes. N Engl J Med. 2013 Oct;369(14):1327–1335.
  • Iqbal N, Parker A, Frederich R, et al. Assessment of the cardiovascular safety of saxagliptin in patients with type 2 diabetes mellitus: pooled analysis of 20 clinical trials. Cardiovasc Diabetol. 2014;13:33.
  • Wu S, Hopper I, Skiba M, et al. Dipeptidyl peptidase-4 inhibitors and cardiovascular outcomes: meta-analysis of randomized clinical trials with 55,141 participants. Cardiovasc Ther. 2014 Aug;32(4):147–158.
  • Savarese G, Perrone-Filardi P, D’Amore C, et al. Cardiovascular effects of dipeptidyl peptidase-4 inhibitors in diabetic patients: A meta-analysis. Int J Cardiol. 2015;181:239–244.
  • White WB, Kupfer S, Zannad F, et al. Cardiovascular mortality in patients with Type 2 diabetes and recent acute coronary syndromes from the EXAMINE Trial. Diabetes Care. 2016 Jul;39(7):1267–1273.
  • National Library of Medicine US. ClinicalTrials.gov [Internet]. [cited 2019 Aug 2]. Available from: https://www.clinicaltrials.gov/
  • Shaffer R. CAROLINA: linagliptin demonstrates CV safety vs. sulfonylurea in type 2 diabetes [Internet]. Endocrine Today. 2019. Available from: https://www.healio.com/endocrinology/diabetes/news/online/%7Bdd88e353-3dbf-4047-a865-2f65895cbaf7%7D/carolina-linagliptin-demonstrates-cv-safety-vs-sulfonylurea-in-type-2-diabetes
  • Ou H-T, Chang K-C, Li C-Y, et al. Comparative cardiovascular risks of dipeptidyl peptidase 4 inhibitors with other second- and third-line antidiabetic drugs in patients with type 2 diabetes. Br J Clin Pharmacol. 2017 Jul;83(7):1556–1570.
  • Ou H-T, Chang K-C, Li C-Y, et al. Risks of cardiovascular diseases associated with dipeptidyl peptidase-4 inhibitors and other antidiabetic drugs in patients with type 2 diabetes: a nation-wide longitudinal study. Cardiovasc Diabetol. 2016;15:41.
  • Schweizer A, Dejager S, Foley JE, et al. Assessing the cardio-cerebrovascular safety of vildagliptin: meta-analysis of adjudicated events from a large Phase III type 2 diabetes population. Diabetes Obes Metab. 2010 Jun;12(6):485–494.
  • Johansen OE, Neubacher D, von Eynatten M, et al. Cardiovascular safety with linagliptin in patients with type 2 diabetes mellitus: a pre-specified, prospective, and adjudicated meta-analysis of a phase 3 programme. Cardiovasc Diabetol. 2012;11:3.
  • McGuire DK, Alexander JH, Johansen OE, et al. Linagliptin effects on heart failure and related outcomes in individuals with Type 2 diabetes mellitus at high cardiovascular and renal risk in CARMELINA. Circulation. 2019 Jan;139(3):351–361.
  • Zannad F, Cannon CP, Cushman WC, et al. Heart failure and mortality outcomes in patients with type 2 diabetes taking alogliptin versus placebo in EXAMINE: a multicentre, randomised, double-blind trial. Lancet. 2015 May;385(9982):2067–2076. (London, England).
  • U.S. Food and Drug Adminstration. FDA Drug Safety Communication: FDA adds warnings about heart failure risk to labels of type 2 diabetes medicines containing saxagliptin and alogliptin [Internet]. 2016. Available from: https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-fda-adds-warnings-about-heart-failure-risk-labels-type-2-diabetes
  • Azoulay L, Filion KB, Platt RW, et al. Association between incretin-based drugs and the risk of acute pancreatitis. JAMA Intern Med. 2016 Oct;176(10):1464–1473.
  • Buse JB, Bethel MA, Green JB, et al. Pancreatic Safety of Sitagliptin in the TECOS Study. Diabetes Care. 2017 Feb;40(2):164–170.
  • Tkac I, Raz I. Combined analysis of three large interventional trials with gliptins indicates increased incidence of acute pancreatitis in patients with Type 2 diabetes. Diabetes Care. 2017 Feb;40(2):284–286.
  • Abbas AS, Dehbi H-M, Ray KK. Cardiovascular and non-cardiovascular safety of dipeptidyl peptidase-4 inhibition: a meta-analysis of randomized controlled cardiovascular outcome trials. Diabetes Obes Metab. 2016 Mar;18(3):295–299.
  • Abrahami D, Douros A, Yin H, et al. Dipeptidyl peptidase-4 inhibitors and incidence of inflammatory bowel disease among patients with type 2 diabetes: population based cohort study. Bmj. 2018;360:k872.
  • Egan AG, Blind E, Dunder K, et al. Pancreatic safety of incretin-based drugs–FDA and EMA assessment. N Engl J Med. 2014 Feb;370(9):794–797.
  • Pinto LC, Rados DV, Barkan SS, et al. Dipeptidyl peptidase-4 inhibitors, pancreatic cancer and acute pancreatitis: A meta-analysis with trial sequential analysis. Sci Rep. 2018 Jan;8(1):782.
  • Zhang Z, Chen X, Lu P, et al. Incretin-based agents in type 2 diabetic patients at cardiovascular risk: compare the effect of GLP-1 agonists and DPP-4 inhibitors on cardiovascular and pancreatic outcomes. Cardiovasc Diabetol. 2017 Mar;16(1):31.
  • Mosenzon O, Leibowitz G, Bhatt DL, et al. Effect of Saxagliptin on Renal Outcomes in the SAVOR-TIMI 53 Trial. Diabetes Care. 2017 Jan;40(1):69–76.
  • Cornel JH, Bakris GL, Stevens SR, et al. Effect of sitagliptin on kidney function and respective cardiovascular outcomes in Type 2 Diabetes: outcomes From TECOS. Diabetes Care. 2016 Dec;39(12):2304–2310.
  • Kim Y-G, Byun J, Yoon D, et al. Renal protective effect of DPP-4 Inhibitors in Type 2 diabetes mellitus patients: a cohort study. J Diabetes Res. 2016;2016:1423191.
  • Chao C-T, Wang J, Wu H-Y, et al. Dipeptidyl peptidase 4 inhibitor use is associated with a lower risk of incident acute kidney injury in patients with diabetes. Oncotarget. 2017 8;Aug(32):53028–53040.
  • Food and Drug Administration US. FDA Drug Safety Communication: FDA warns that DPP-4 inhibitors for type 2 diabetes may cause severe joint pain [Internet]. 2015 [cited 2019 Feb 8]. Available from: https://www.fda.gov/Drugs/DrugSafety/ucm459579.htm
  • Men P, He N, Song C, et al. Dipeptidyl peptidase-4 inhibitors and risk of arthralgia: A systematic review and meta-analysis. Diabetes Metab. 2017 Dec;43(6):493–500.
  • Mascolo A, Rafaniello C, Sportiello L, et al. Dipeptidyl Peptidase (DPP)-4 inhibitor-induced arthritis/arthralgia: a review of clinical cases. Drug Saf. 2016 May;39(5):401–407.
  • Kridin K, Bergman R. Association of bullous pemphigoid with dipeptidyl-peptidase 4 inhibitors in patients with diabetes: estimating the risk of the new agents and characterizing the patients. JAMA Dermatol. 2018 Oct;154(10):1152–1158.
  • Lee SG, Lee HJ, Yoon MS, et al. Association of dipeptidyl peptidase 4 inhibitor use with risk of bullous pemphigoid in patients with diabetes. JAMA Dermatol. 2019 Feb;155(2):172–177.
  • Gilbert MP, Bunn JY, Maple R, et al. The effect of sitagliptin on markers of bone metabolism in patients with Type 2 diabetes mellitusitle. In: 2183-PO [Internet]. Orlando, FL; 2010. Available from: https://professional.diabetes.org/abstract/effect-sitagliptin-markers-bone-metabolism-patients-type-2-diabetes-mellitus
  • Mamza J, Marlin C, Wang C, et al. DPP-4 inhibitor therapy and bone fractures in people with Type 2 diabetes - A systematic review and meta-analysis. Diabetes Res Clin Pract. 2016;116:288–298.
  • Monami M, Dicembrini I, Antenore A, et al. Dipeptidyl peptidase-4 inhibitors and bone fractures: a meta-analysis of randomized clinical trials. Diabetes Care. 2011 Nov;34(11):2474–2476.
  • Fu J, Zhu J, Hao Y, et al. Dipeptidyl peptidase-4 inhibitors and fracture risk: an updated meta-analysis of randomized clinical trials. Sci Rep. 2016;6:29104.
  • Yang J, Huang C, Wu S, et al. The effects of dipeptidyl peptidase-4 inhibitors on bone fracture among patients with type 2 diabetes mellitus: A network meta-analysis of randomized controlled trials. PLoS One. 2017;12(12):e0187537.
  • Mikhail N. Place of sodium-glucose co-transporter type 2 inhibitors for treatment of type 2 diabetes. World J Diabetes. 2014 Dec;5(6):854–859.
  • Zinman B, Wanner C, Lachin JM, et al. Empagliflozin, cardiovascular outcomes, and mortality in Type 2 diabetes. N Engl J Med. 2015 Nov;373(22):2117–2128.
  • Neal B, Perkovic V, Mahaffey KW, et al. Canagliflozin and Cardiovascular and Renal Events in Type 2 Diabetes. N Engl J Med. 2017 Aug;377(7):644–657.
  • Persson F, Nystrom T, Jorgensen ME, et al. Dapagliflozin is associated with lower risk of cardiovascular events and all-cause mortality in people with type 2 diabetes (CVD-REAL Nordic) when compared with dipeptidyl peptidase-4 inhibitor therapy: A multinational observational study. Diabetes Obes Metab. 2018 Feb;20(2):344–351.
  • Food and Drug Administration US. FDA approves Jardiance to reduce cardiovascular death in adults with type 2 diabetes [Internet]. 2016 [cited 2019 Feb 8]. Available from: https://www.fda.gov/newsevents/newsroom/pressannouncements/ucm531517.htm.
  • Wiviott SD, Raz I, Bonaca MP, et al. Dapagliflozin and cardiovascular outcomes in Type 2 diabetes. N Engl J Med. 2019 Jan;380(4):347–357.
  • Wiviott SD, Raz I, Bonaca MP, et al. The design and rationale for the Dapagliflozin Effect on Cardiovascular Events (DECLARE)-TIMI 58 Trial. Am Heart J. 2018;200:83–89.
  • Macha S, Mattheus M, Halabi A, et al. Pharmacokinetics, pharmacodynamics and safety of empagliflozin, a sodium glucose cotransporter 2 (SGLT2) inhibitor, in subjects with renal impairment. Diabetes Obes Metab. 2014 Mar;16(3):215–222.
  • Fioretto P, Zambon A, Rossato M, et al. SGLT2 Inhibitors and the Diabetic Kidney. Diabetes Care. 2016 Aug;39(Suppl 2):S165–71.
  • Food and Drug Administration US. FDA Drug Safety Comunication FDA strengthens kidney warnings for diabetes medicines canagliflozin (Invokana, Invokamet) and dapagliflozin (Farxiga, Xigduo XR) [Internet]. 2016 [cited 2019 Feb 8]. Available from: https://www.fda.gov/downloads/Drugs/DrugSafety/UCM506772.pdf
  • Bode B, Stenlof K, Harris S, et al. Long-term efficacy and safety of canagliflozin over 104 weeks in patients aged 55-80 years with type 2 diabetes. Diabetes Obes Metab. 2015 Mar;17(3):294–303.
  • Elmore LK, Baggett S, Kyle JA, et al. A review of the efficacy and safety of canagliflozin in elderly patients with type 2 diabetes. Consult Pharm. 2014;29(5):335–346.
  • Perkovic V, Jardine MJ, Neal B, et al. Canagliflozin and renal outcomes in Type 2 diabetes and nephropathy. N Engl J Med. 2019 Apr.
  • Jardine MJ, Mahaffey KW, Neal B, et al. The canagliflozin and renal endpoints in diabetes with established nephropathy Clinical Evaluation (CREDENCE) Study Rationale, Design, and Baseline Characteristics. Am J Nephrol. 2017 Dec;46(6):462–472.
  • Perkovic V, de Zeeuw D, Mahaffey KW, et al. Canagliflozin and renal outcomes in type 2 diabetes: results from the CANVAS Program randomised clinical trials. Lancet Diabetes Endocrinol. 2018 Sep;6(9):691–704.
  • Food and Drug Administration US. FDA warns about rare occurrences of a serious infection of the genital area with SGLT2 inhibitors for diabetes [Internet]. 2018 [cited 2019 Feb 8]. Available from: https://www.fda.gov/Drugs/DrugSafety/ucm617360.htm
  • Food and Drug Administration US. FDA warns that SGLT2 inhibitors for diabetes may result in a serious condition of too much acid in the blood [Internet]. 2015 [cited 2019 Feb 8]. Available from: https://www.fda.gov/downloads/Drugs/DrugSafety/UCM446954.pdf
  • Kaku K, Watada H, Iwamoto Y, et al. Efficacy and safety of monotherapy with the novel sodium/glucose cotransporter-2 inhibitor tofogliflozin in Japanese patients with type 2 diabetes mellitus: a combined Phase 2 and 3 randomized, placebo-controlled, double-blind, parallel-group comparative. Cardiovasc Diabetol. 2014;13:65.
  • Taylor SI, Blau JE, Rother KI. SGLT2 Inhibitors May Predispose to Ketoacidosis. J Clin Endocrinol Metab. 2015 Aug;100(8):2849–2852.
  • Taylor SI, Blau JE, Rother KI. Possible adverse effects of SGLT2 inhibitors on bone. Lancet Diabetes Endocrinol. 2015 Jan;3(1):8–10.
  • Kohan DE, Fioretto P, Tang W, et al. Long-term study of patients with type 2 diabetes and moderate renal impairment shows that dapagliflozin reduces weight and blood pressure but does not improve glycemic control. Kidney Int. 2014 Apr;85(4):962–971.
  • Watts NB, Bilezikian JP, Usiskin K, et al. Effects of canagliflozin on fracture risk in patients with type 2 diabetes mellitus. J Clin Endocrinol Metab. 2016 Jan;101(1):157–166.
  • Fralick M, Kim SC, Schneeweiss S, et al. Fracture risk after initiation of use of canagliflozin: a cohort study. Ann Intern Med. 2019;170:155.
  • Food and Drug Administration US. FDA Drug Safety Communication: FDA confirms increased risk of leg and foot amputations with the diabetes medicine canagliflozin (Invokana, Invokamet, Invokamet XR) [Internet]. 2017 [cited 2019 Feb 8]. Available from: https://www.fda.gov/Drugs/DrugSafety/ucm557507.htm
  • Khouri C, Cracowski J-L, Roustit M. SGLT-2 inhibitors and the risk of lower-limb amputation: is this a class effect? Diabetes Obes Metab. 2018 Jun;20(6):1531–1534.
  • Ryan PB, Buse JB, Schuemie MJ, et al. Comparative effectiveness of canagliflozin, SGLT2 inhibitors and non-SGLT2 inhibitors on the risk of hospitalization for heart failure and amputation in patients with type 2 diabetes mellitus: a real-world meta-analysis of 4 observational databases (OBSER. Diabetes Obes Metab. 2018 Nov;20(11):2585–2597.
  • Ptaszynska A, Cohen SM, Messing EM, et al. Assessing bladder cancer risk in type 2 diabetes clinical trials: the dapagliflozin drug development program as a “Case Study”. Diabetes Ther. 2015 Sep;6(3):357–375.
  • Kodama K, Tojjar D, Yamada S, et al. Ethnic differences in the relationship between insulin sensitivity and insulin response: a systematic review and meta-analysis. Diabetes Care. 2013 Jun;36(6):1789–1796.
  • Seino Y, Kuwata H, Yabe D. Incretin-based drugs for type 2 diabetes: focus on East Asian perspectives. J Diabetes Investig. 2016 Apr;7(Suppl 1):102–109.
  • Kim YG, Hahn S, Oh TJ, et al. Differences in the glucose-lowering efficacy of dipeptidyl peptidase-4 inhibitors between Asians and non-Asians: a systematic review and meta-analysis. Diabetologia. 2013 Apr;56(4):696–708.
  • Kim YG, Hahn S, Oh TJ, et al. Differences in the HbA1c-lowering efficacy of glucagon-like peptide-1 analogues between Asians and non-Asians: a systematic review and meta-analysis. Diabetes Obes Metab. 2014 Oct;16(10):900–909.
  • Iwasaki M, Hoshian F, Tsuji T, et al. Predicting efficacy of dipeptidyl peptidase-4 inhibitors in patients with type 2 diabetes: association of glycated hemoglobin reduction with serum eicosapentaenoic acid and docosahexaenoic acid levels. J Diabetes Investig. 2012 Oct;3(5):464–467.
  • Misra A, Khurana L. Obesity-related non-communicable diseases: south Asians vs White Caucasians. Int J Obes. 2011 Feb;35(2):167–187. (Lond).
  • Patel P, Abate N. Role of subcutaneous adipose tissue in the pathogenesis of insulin resistance. J Obes. 2013;2013:489187.
  • Sleddering MA, Bakker LEH, Janssen LGM, et al. Higher insulin and glucagon-like peptide-1 (GLP-1) levels in healthy, young South Asians as compared to Caucasians during an oral glucose tolerance test. Metabolism. 2014 Feb;63(2):226–232.
  • Singh AK. Incretin response in Asian type 2 diabetes: are Indians different? Indian J Endocrinol Metab. 2015;19(1):30–38.
  • Yamamoto-Honda R, Takahashi Y, Mori Y, et al. Changes in antidiabetic drug prescription and glycemic control trends in elderly patients with type 2 diabetes mellitus from 2005-2013: an analysis of the National Center Diabetes Database (NCDD-03). Intern Med. 2018 May;57(9):1229–1240.
  • Yabe D, Seino Y. Dipeptidyl peptidase-4 inhibitors and sulfonylureas for type 2 diabetes: friend or foe? J Diabetes Investig. 2014 Sep;5(5):475–477.
  • de Heer J, Holst JJ. Sulfonylurea compounds uncouple the glucose dependence of the insulinotropic effect of glucagon-like peptide 1. Diabetes. 2007 Feb;56(2):438–443.
  • Mukai E, Fujimoto S, Sato H, et al. Exendin-4 suppresses SRC activation and reactive oxygen species production in diabetic Goto-Kakizaki rat islets in an Epac-dependent manner. Diabetes. 2011 Jan;60(1):218–226.
  • Lim LL, Tan ATB, Moses K, et al. Place of sodium-glucose cotransporter-2 inhibitors in East Asian subjects with type 2 diabetes mellitus: insights into the management of Asian phenotype. J Diabetes Complications. 2017 Feb;31(2):494–503.
  • Rhee EJ. Diabetes in Asians. Endocrinol Metab. 2015 Sep;30(3):263–269. (Seoul, Korea).
  • Min SH, Yoon J-H, Hahn S, et al. Comparison between SGLT2 inhibitors and DPP4 inhibitors added to insulin therapy in type 2 diabetes: a systematic review with indirect comparison meta-analysis. Diabetes Metab Res Rev. 2017 Jan;33(1):e2818.
  • Mishriky BM, Tanenberg RJ, Sewell KA, et al. Comparing SGLT-2 inhibitors to DPP-4 inhibitors as an add-on therapy to metformin in patients with type 2 diabetes: A systematic review and meta-analysis. Diabetes Metab. 2018 Mar;44(2):112–120.
  • Wang Z, Sun J, Han R, et al. Efficacy and safety of sodium-glucose cotransporter-2 inhibitors versus dipeptidyl peptidase-4 inhibitors as monotherapy or add-on to metformin in patients with type 2 diabetes mellitus: A systematic review and meta-analysis. Diabetes Obes Metab. 2018 Jan;20(1):113–120.
  • Scheen AJ. Cardiovascular Effects of New Oral Glucose-Lowering Agents: DPP-4 and SGLT-2 Inhibitors. Circ Res. 2018 May;122(10):1439–1459.
  • Scheen AJ. Effects of glucose-lowering agents on surrogate endpoints and hard clinical renal outcomes in patients with type 2 diabetes. Diabetes Metab. 2019 Apr;45(2):110–121.
  • Scheen AJ. Cardiovascular effects of dipeptidyl peptidase-4 inhibitors: from risk factors to clinical outcomes. Postgrad Med. 2013 May;125(3):7–20.
  • Abdul-Ghani M, Del Prato S, Chilton R, et al. SGLT2 inhibitors and cardiovascular risk: lessons learned from the EMPA-REG OUTCOME Study. Diabetes Care. 2016 May;39(5):717–725.
  • Inzucchi SE, Zinman B, Fitchett D, et al. How does empagliflozin reduce cardiovascular mortality? Insights from a mediation analysis of the EMPA-REG OUTCOME Trial. Diabetes Care. 2018 Feb;41(2):356–363.
  • Cannon CP, McGuire DK, Pratley R, et al. Design and baseline characteristics of the eValuation of ERTugliflozin effIcacy and Safety CardioVascular outcomes trial (VERTIS-CV). Am Heart J. 2018;206:11–23.
  • Schott G, Martinez YV, Ediriweera de Silva RE, et al. Effectiveness and safety of dipeptidyl peptidase 4 inhibitors in the management of type 2 diabetes in older adults: a systematic review and development of recommendations to reduce inappropriate prescribing. BMC Geriatr. 2017 Oct;17(Suppl 1):226.
  • Kambara T, Shibata R, Osanai H, et al. Use of sodium-glucose cotransporter 2 inhibitors in older patients with type 2 diabetes mellitus. Geriatr Gerontol Int. 2018 Jan;18(1):108–114.
  • Perna S, Mainardi M, Astrone P, et al. 12-month effects of incretins versus SGLT2-Inhibitors on cognitive performance and metabolic profile. A randomized clinical trial in the elderly with Type-2 diabetes mellitus. Clin Pharmacol. 2018;10:141–151.
  • Bailey CJ, Day C. Fixed-dose single tablet antidiabetic combinations. Diabetes Obes Metab. 2009 Jun;11(6):527–533.
  • Hutchins V, Zhang B, Fleurence RL, et al. A systematic review of adherence, treatment satisfaction and costs, in fixed-dose combination regimens in type 2 diabetes. Curr Med Res Opin. 2011 Jun;27(6):1157–1168.

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