Ipragliflozin Vs Sitagliptin in T2D with Metformin: A glimpse of NISM study
According to US and European guidelines, sodium - glucose co - transporter - 2 (SGLT2) inhibitors are considered second‐line drugs after metformin for patients with type 2 diabetes and atherosclerotic cardiovascular disease (ASCVD) or chronic kidney disease. In a recent study, researchers have found that sitagliptin, a DPP4 inhibitor (DPP-4i), effectively reduces the HbA1c levels better than Ipragliflozin (SGLPT2i) by the end of 24 weeks; However, they found no significant difference in HbA1c and body weight by the end of 52 weeks. They also found that ipragliflozin improved some atherosclerotic cardiovascular disease risk factors. The research has been published in the journal DIABETES, OBESITY AND METABOLISM on January 08, 2021.
Dipeptidyl peptidase‐4 (DPP‐4) inhibitors are widely used in the treatment of diabetes because they do not cause weight gain and are associated with a low risk of hypoglycaemia. SGLT2 inhibitors are also widely used because of their weight‐loss effects and evidence of prevention of ASCVD, chronic kidney disease, and heart failure. However, the results of studies comparing the efficacy of these drugs as second‐line drugs after metformin in patients at low‐risk of ASCVD are controversial. Previous study findings indicate that a 24‐week period is not sufficient, to evaluate the efficacy of either drug and suggests for a long‐term randomized controlled trial to produce meaningful results. Therefore, researchers of Japan conducted NISM study to compare the long‐term efficacy of sodium‐glucose co‐transporter‐2 inhibitors and dipeptidyl peptidase‐4 inhibitors as second‐line drugs after metformin for patients, not at high risk of atherosclerotic cardiovascular disease (ASCVD).
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