130-LB: Retrospective Evaluation of Treatment Patterns in a Real-Life Setting Environment with Dapagliflozin or DPP-4 Inhibitors as Add-On Therapy in Uncontrolled DM2 Patients Who Previously Failed on Other Regimens

Mexico is one of LatinAmerica countries with the highest prevalence (14.4%) of DM. Medical institutions face the challenge to provide medical care to T2DM patients that failed to several antidiabetic regimens. We conducted a retrospective study to assess the response to dapagliflozin (Dapa) or DPP-4-inhibitors (DPP-4i) as added-on therapy in T2DM patients with failure to previous medications.

Objectives: Compare subjects with ≥5% improvement of the weighted sum of the three variables of the composite variable (HbA1c plus body weight (BW) plus blood pressure (BP) by the end of the 74-week observation period from index date) and proportion of patient achieving HBA1c of 7%.

Inclusion Criteria: T2DM subjects ≥18 years old with failure to any previous antidiabetic medication and HbA1c% ≥7 that started Dapa or DPP-4i as add-on to other antidiabetic drugs from August 2014 to Jun 2018.

Statistical Methods and Analysis: A propensity score matching model (nearest neighbor algorithm) was used, covariates included were treatment regimen, TC, LDL-c, HbA1c, BW, systolic BP and age.

Results: Of 1800 subjects, 221 met statistical matching criteria. No differences in basal characteristics of age, SBP, CrCl, but DAPA group had higher basal HbA1c (8.68±1.59 vs. 8.19±1.4, p<0.01). Dapa group had a significant improvement (>5%) in the composite variable compared to DPP-4i at 24 (76.9% vs. 46%, p<0.01), 52 (82.4% vs. 49.5%, p<0.01) and 76 weeks(84.6% vs. 39.2%, p<0.01). Patients with HbA1c goal of <7% in Dapa group compared to iDPP-4 at 24 (44.3% vs. 29.9%, p<0.01), 52 (48.9% vs. 29.1%, p<0.01) and 76 weeks (51.9% vs. 21.8%, p<0.01).

Conclusion: In patients with uncontrolled T2DM who have failed to previous antidiabetic therapies, the add-on of dapagliflozin significantly provides reductions of HbA1c, glucose, weight and blood with more patients achieving glucose control goals compared to iDPP-4.