effects of dapagliflozin, an sglt2.ppt

7/24/2019 Effects of Dapagliflozin, an SGLT2.ppt

1/20

Efects o Dapagliozin, an SGLT2Inhibitor, on HbA1c, o!" #eight,

an! H"pogl"ce$ia %is& in 'atients#ith T"pe 2 Diabetes Ina!e()atel"

*ontrolle! on 'ioglitazone

+onotherap"

Annis %a&h$aati

'e$bi$bing- !r %. oo 'ra$ono, Sp'D/0E+D


2/20

I!entitas )rnal

)!)l - Efects o Dapagliozin, an SGLT2Inhibitor, on HbA1c, o!" #eight, an!H"pogl"ce$ia %is& in 'atients #ith T"pe 2

Diabetes Ina!e()atel" *ontrolle! on'ioglitazone +onotherap"

'en)lis- )lio rosenstoc& et al

')bli&asi - Diabetes care, ol)$e 34, 5)l"2612


3/20

I7T%8D9*TI87

SGLT2 inhibitor : hipergl"ce$ia :in!)ce $il! os$otic !i)resis an! ;)rinar" e


4/20

'ioglitazone loers gl)cose b"

enhancing ins)lin sensitiit". Saet" concerns o )i! retention,

eight gain, *H, bone ract)res,

bla!!er cancer has li$ite! its )se assecon! line therap" hen $etor$inis not tolerate! or as triple oraltherap"


5/20

Dapagliozin gl)cos)ria !i)resis= caloric loss concern o eightgain = )i! retentionBe!e$a.

The ai$ to e


6/20

S)b5ects

Inclusion Criteria 1 ".o ith asting */pepti!e 1.6 ngB$L an! +I

F 4.6

2 )l" 266 an! )l" 266. The st)!" too&place

at 164 sites in Argentina, *ana!a,In!ia, +e


7/20

+etho!s

ran!o$ize!, !o)ble blin!, placebo/controlle!, parallel gro)p to e


8/20

Treat$ent/naie patients or thosereceiing $etor$in, S9, or T?D entere! a

16/ee& pioglitazone !ose/opti$izationperio! ith onl" pioglitazone.

The" ere ran!o$ize!, along ith patientspreio)sl" receiing pioglitazone 36 $g,

to ee&s o !o)ble/blin! !apagliozin4$g >n J 11@ or 16$g >n J 16@ orplacebo >n J 13@ eer" !a" pl)s open/label pioglitazone.


9/20

'ri$ar" en! point changes ro$

baseline in HbA1c, 'G, ''G, bo!"eight at ee& 2 )sing A7*8A$o!el


10/20


11/20


12/20

%es)lt


13/20

Disc)ssion

In this st)!", the a!!ition o!apagliozin to pioglitazone loere!HbA1c an! eight gain in T2D+

ina!e()atel" controlle! onpioglitazone alone.

Dapagliozin acts in the &i!ne" b"

inhibiting the reabsorption o gl)cose: 'G , : ''G


14/20

The gl)cos)ria in!)ce! b" SGLT/2inhibition s)specte! lea!ing toh"pogl"ce$ia, 9TIs, an! genital

inections.

H"pogl"ce$ia eents ere rare inthis st)!".


15/20

*onsistent ith preio)s reports genital inections ere higher in patientson !apagliozin than on placebo.

7one o these genital inections ereserio)s, an! all respon!e! toanti$icrobial treat$ent.

Dapagliozin, acting as a $il! !i)retic,$itigate the )i! retaining efects opioglitazone


16/20

*oncl)sion

The !irect re$oal o gl)cose b"!apagliozin co$ple$ents theins)lin/sensitizing action o

pioglitazone


17/20

*ritical Appraisal

Are the results Valid

1. #as the assign$ent o patients to treat$ents ran!o$ize!K An!

as the ran!o$ization list conceale!K "es

2. #as ollo/)p o patients s)Ccientl" long an! co$pleteK "es3. #ere patients anal"ze! in the gro)ps hich the" ere ran!o$ize!K

"es

. #ere patients an! clinicians &ept blin!M to treat$entK "es

4. #ere the gro)ps treate! e()all", apart ro$ the e


18/20

Are the ali! res)lts o thisran!o$ize! st)!" i$portantK

1. #hat is the $agnit)!e o the treat$ent efectK

7o !ata

2. Ho precise is this esti$ate o the treat$ent

efectK 7o !ata

A th li! i t t


19/20

Are these ali!, i$portantres)lts applicable to o)r

patientK1. Is o)r patient so !iferent ro$ those in thest)!" that its res)lts cannot appl"K 7o

2. Is the treat$ent easible in o)r settingK Oes

3. #hat are o)r patientPs potential beneQts an!

har$s or$ the therap"K

eneQt- potential co$bination that balancesell the beneQts an! ris&s o therap" or T2D+.

Har$ - Has not been proe! as gol! stan!ar!therap"


20/20

Than& "o)

effects of dapagliflozin, an sglt2.ppt

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