Two years with GIOIA 'Effects of gliflozins and gliptins on markers of cardiovascular damage in type 2 diabetes': A prospective, multicentre, quasi-experimental study on sodium-glucose cotransporter 2 and dipeptidyl peptidase-4 inhibitors in diabetes clinical practice.

Autor: Longo M; Department of Advanced Medical and Surgical Sciences, Division of Endocrinology and Diabetes, University of Campania 'Luigi Vanvitelli', Naples, Italy., Caruso P; Department of Advanced Medical and Surgical Sciences, Division of Endocrinology and Diabetes, University of Campania 'Luigi Vanvitelli', Naples, Italy., Scappaticcio L; Department of Advanced Medical and Surgical Sciences, Division of Endocrinology and Diabetes, University of Campania 'Luigi Vanvitelli', Naples, Italy., Maiorino MI; Department of Advanced Medical and Surgical Sciences, Division of Endocrinology and Diabetes, University of Campania 'Luigi Vanvitelli', Naples, Italy., Bellastella G; Department of Advanced Medical and Surgical Sciences, Division of Endocrinology and Diabetes, University of Campania 'Luigi Vanvitelli', Naples, Italy., Capuano A; Section of Pharmacology 'L. Donatelli', Department of Experimental Medicine, University of Campania 'Luigi Vanvitelli', Campania Regional Centre for Pharmacovigilance and Pharmacoepidemiology, Naples, Italy., Esposito K; Department of Advanced Medical and Surgical Sciences, Division of Endocrinology and Diabetes, University of Campania 'Luigi Vanvitelli', Naples, Italy., Giugliano D; Department of Advanced Medical and Surgical Sciences, Division of Endocrinology and Diabetes, University of Campania 'Luigi Vanvitelli', Naples, Italy.
Jazyk: angličtina
Zdroj: Diabetes, obesity & metabolism [Diabetes Obes Metab] 2024 Apr; Vol. 26 (4), pp. 1492-1501. Date of Electronic Publication: 2024 Jan 17.
DOI: 10.1111/dom.15451
Abstrakt: Aim: To assess and compare the metabolic and vascular effectiveness of sodium-glucose cotransporter 2 inhibitors (SGLT-2i) and dipeptidyl peptidase-4 inhibitors (DPP-4i) in the clinical practice of patients with type 2 diabetes in Italy.
Materials and Methods: GIOIA is a 2-year prospective, multicentre, quasi-experimental study that enrolled patients with type 2 diabetes initiating SGLT-2i or DPP-4i for inadequate glycaemic control [glycated haemoglobin (HbA1c) >7%] between March 2018 and March 2021. The primary endpoints were changes in markers of organ damage [carotid intima-media thickness (CIMT), albuminuria, myocardial function] and HbA1c from baseline to year 2.
Results: In total, 1150 patients were enrolled in the study (SGLT-2i n = 580, DPP-4i n = 570). Patients initiated on SGLT-2i were younger (about 6 years) and heavier (about 11 kg), had higher HbA1c level (1% more), more albuminuria and cardiovascular events (16% more) than patients initiated on DPP-4i. CIMT and echocardiographic parameters were not significantly different. Propensity score matching yielded two groups, each consisting of 155 patients with diabetes with similar baseline characteristics. Despite a significant similar reduction in HbA1c levels in both groups (-0.8%), more patients on SGLT-2i had regression of CIMT and albuminuria (22% and 10%, respectively, p < .001 vs. DPP-4i); more patients on DPP-4i had progression of CIMT and albuminuria (23% and 28%, respectively, p < .001 vs. SGLT-2i). Left ventricular ejection fraction improved slightly (3%, p = .043) on SGLT-2i only.
Conclusions: In a real-world setting, both SGLT-2i and DPP-4i improve glycaemic control persisting after 2 years of treatment, with a robust effect on both CIMT and albuminuria regression for SGLT-2i as compared with DPP-4i in the propensity score matching.
(© 2024 John Wiley & Sons Ltd.)
Databáze: MEDLINE
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