Treatment Outcomes Following Initiation of Dapagliflozin or Basal Supported Oral Therapy Among Type 2 Diabetes Patients In Primary Care Practices In Germany

Aim of this study was to compare real-world treatment outcomes of dapagliflozin and basal supported oral therapy (BOT) among therapy in patients with type 2 diabetes in Germany. Patients from 983 primary care practices who started dapagliflozin therapy or BOT between 01/12/2012 and 31/07/2015 (index date) were selected in the IMS Disease Analyzer database. Changes from baseline in HbA1c and weight were evaluated in the time periods of 3-9 months. Dapagliflozin patients who additionally received insulin prescriptions and BOT patients who received SGLT-2 prescriptions were excluded from the analysis. Finally, 766 dapagliflozin patients were matched (1:1) to BOT patients by propensity scores based on age, sex, health insurance coverage, diabetologist care, oral antihyperglycemic therapy (metformin, sulfonylurea, DPP-4 inhibitors), baseline HbA1c/BMI value and therapy duration till the last HbA1c/weight documentation after index date. 766 dapagliflozin and 766 BOT patients were eligible for the study. Mean (SD) HbA1c (%) was decreased from 8.9 (1.2) at baseline to 7.7 (1.1) in 3-6 months in dapagliflozin patients and from 8.7 (1.1) to 7.7 (1.2) in BOT patients. There was no significant difference between dapagliflozin and BOT in the HbA1c reduction (p=0.792). A statistically significant reduction in mean body weight was observed in patients treated with dapagliflozin at 3-9 months (-3.1 kg) but no body weight reduction was achieved in BOT patients (0.0 kg). There was a significant difference between dapagliflozin and BOT in the body weight reduction (p<0.001). In clinical practice SGLT-2 (dapagliflozin) treatment was associated with improved glycemic control but had no significant difference compared with BOT. On the other side, a significant reduction of body weight could be observed in dapagliflozin bot not in BOT patients. Further research is needed to evaluate the differences in insulin and innovative OAD therapies more in detail.