Efficacy and Side Effect Profile of Empagliflozin and Dapagliflozin in Combination Therapy: A Real-World Experience

ABSTRACT

Objective: Sodium-glucose co-transporter inhibitors (SGLT2i) offer significant cardiovascular benefits, although several adverse events have also been reported with their use. The present study aimed to determine how the preference of SGLT2i is influenced by the adverse effects and the cardiovascular and renal benefits they demonstrate in clinical practice. In addition, the effectiveness of different SGLT2i in combination therapy was revealed. Material and Methods: The patients in their third to the eighth month of SGLT2i treatment, who were admitted to our out-patient clinic for the followup evaluation of fasting plasma glucose (FPG) level, hemoglobin A1c (HbA1c) level, and body weight, were included in the present study. The follow-up evaluations were defined as those conducted at the sixth month and the final month of follow-up visits. The final-month evaluation was defined as the one conducted upon the patients’ last admission to the out-patient clinic between 10 and 14 months of the SGLT2i treatment. Results: A total of 244 patients received the SGLT2i treatment. Among the patients who fulfilled the inclusion criteria, 52 patients were in the empagliflozin group and 37 patients were in the dapagliflozin group. The FPG and HbA1c levels declined significantly in both empagliflozin (p=0.004 and p=0.002) and dapagliflozin (p=0.04, p<0.001) groups. In the combination therapy involving both the SGLT2i, the FPG and HbA1c levels decreased considerably (p<0.001). Urinary tract infection was observed as the most common complication in both empagliflozin and dapagliflozin groups. Conclusion: In Turkey, SGLT2i preference in Type 2 diabetes mellitus (T2DM) is closely associated with the data reported in the related literature. Empagliflozin and dapagliflozin, in all combinations, are, therefore, considered effective treatment options for T2DM. It is recommended to select a targeted patient population when considering the adverse effect profile as there is a trend of inconsistent follow-up in Turkey.