TOPLINE:
A triple combination therapy (TCT) of metformin, dapagliflozin, and saxagliptin is an effective and safe treatment option for drug-naive patients with type 2 diabetes (T2D) compared with stepwise add-on therapy.
METHODOLOGY:
- Current guidelines recommend early combination therapy to extend the time to treatment failure, reduce the risk for diabetic complications, and prevent clinical inertia in patients with T2D.
- This randomized controlled open-label trial conducted at nine sites in South Korea included 105 drug-naive patients with T2D (mean age, 49.5 years; 32.4% women) who either received triple therapy (metformin, dapagliflozin, and saxagliptin) or stepwise add-on therapy (initiated with metformin, followed by glimepiride and sitagliptin for those with baseline A1c levels
- The primary outcome was the proportion of patients who achieved A1c levels
- The secondary outcomes were the proportion of patients whose A1c levels dropped to
TAKEAWAY:
- At week 104, a higher proportion of patients in the triple therapy group achieved the primary outcome than those in the stepwise add-on therapy group (39.0% vs 17.1%; P = .027).
- In both groups, a similar proportion of patients (46.3%) achieved A1c levels P
- Triple therapy also provided greater reductions in body weight (between-group difference, −3.64 kg; P
- Overall, TCT was well tolerated with fewer adverse events than stepwise add-on therapy.
IN PRACTICE:
The authors wrote, “Although the glycemic efficacy of each drug in the TCT [triple combination therapy] was modest, the combination of these drugs resulted in a 2-year durable glycemic efficacy, with greater than a 2.5% reduction in A1c levels from baseline. The overall results of this study suggest a novel strategy for initial combination therapy in newly diagnosed T2D patients.”
SOURCE:
The study was led by Nam Hoon Kim, MD, of the Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea. It was published online in Diabetes, Obesity and Metabolism.
LIMITATIONS:
The study had a relatively small sample size as compared with previous clinical trials. More people in the standard therapy group had A1c levels ≥ 9.0%, which resulted in more than double the number of people receiving dual combination therapy over monotherapy in that group. The trial duration was insufficient to evaluate the cardiovascular outcomes.
DISCLOSURES:
The study was funded by AstraZeneca. Some authors reported financial ties with AstraZeneca and other pharmaceutical and medical device companies as members of advisory boards or recipients of grants, consulting fees, honoraria, or lecture fees.
Source link : https://www.medscape.com/viewarticle/initial-triple-therapy-shows-promise-drug-naive-t2d-2024a1000c50?src=rss
Author :
Publish date : 2024-07-01 07:06:20
Copyright for syndicated content belongs to the linked Source.