860-P: Effects of the Combination Treatment with SGLT2 Inhibitors and GLP1 Receptor Agonists among Japanese Patients with Type 2 Diabetes Mellitus and Obesity

Background: The combination treatment of sodium glucose co-transporter 2 inhibitors (SGLT2is) and glucagon-like peptide-1 receptor agonists (GLP1Ras) is increasing in clinical practice. We previously reported that the preceding drug did not influence the renal outcomes in patients with this combination treatment, however, the decrease in body weight (BW) was larger in the GLP1Ra-preceding patients compared to the SGLT2i-preceding patients. In this post-hoc study, we analyzed the difference in the effect by the combination treatment on clinical findings depending on the presence or absence of obesity.

Method: A retrospective study was conducted in 643 patients who were treated with both SGLT2i and GLP1Ra. Patients were divided into two groups; 373 patients with body mass index (BMI) of <30 and 270 patients with BMI≥30.The comparison between two groups was performed by propensity score inverse probability weighting method using a generalized linear model.

Results: After the combination treatment, significant larger decrease in BMI was observed in patient with BMI≥30 compared to those with BMI<30 (1.0[95% confidence interval (CI), 0.5,1.6, p<0.001]. There were no significant differences of the change in hemoglobin A1c, mean arterial pressure, and alanine aminotransferase, however, the achievement rate for the target of <130/80 mmHg tended to low in patients with BMI≥30 compared to those with BMI<30, with odds ratio of 0.74 [95%CI, 0.50, 1.11, p=0.15].

Conclusion: After the combination treatment of SGLT2i and GLP1Ra, greater BW loss was observed in obese patients, however non-obese patients might be more advantageous in blood pressure control.