Real-world experience with Dapagliflozin in people with type-2 diabetes living in Western Sydney: Beneficial impact on biomarkers and reasons for discontinuation. — ASN Events
  1. Schedule
  2. ADS Clinical Poster Session - Therapy of type 2 diabetes
  3. Real-world experience with Dapagliflozin in people with type-2 diabetes living in Western Sydney: Beneficial impact on biomarkers and reasons for discontinuation.

Real-world experience with Dapagliflozin in people with type-2 diabetes living in Western Sydney: Beneficial impact on biomarkers and reasons for discontinuation. (#257)

Mani Manoharan 1 2 , Tristan Nguyen 1 , Adrian Yeung 3 , Xiaoqi Feng 1 2 , Thomas Astell-Burt 4 , Mark McLean 2 3 , Glen Maberly 1 2
  1. Endocrinology, Blacktown Hospital, Western Sydney Local Health District, Sydney, NSW, Australia
  2. School Of Medicine, University of Western Sydney, Sydney, NSW, Australia
  3. Endocrinology, Blacktown Hospital, Western Sydney Local Health District, Sydney, NSW, Australia
  4. School of Health and Society, University of Wollongong, Wollongong, NSW, Australia

Introduction:
Dapagliflozin – a sodium-glucose co transport-2 (SGLT2) inhibitor has recently been introduced into clinical use for type 2 diabetes (T2DM) in Australia. We conducted an audit of patients attending General Practice and Blacktown Hospital Outpatient clinics who commenced dapagliflozin and followed up 3-6 months later.

Objectives:
To monitor trends in T2DM control before and 3-6 months after introduction of dapagliflozin and reasons for discontinuation.

Methodology:
98 Patients commencing dapagliflozin were identified from the outpatient clinics and GP case conference sessions. Clinic databases were used to collect patient demographic and clinical data: HbA1c, weight and blood pressure (BP). Multilevel linear regression was used to analyse change in each variable (adjusting for age and gender). Reasons for discontinuation of dapagliflozin were recorded.

Results:
Before dapagliflozin, mean HbA1c concentration was 9.1% (95% CI 8.6 to 9.7), weight 102.9kg (93.7 - 111.0), systolic BP 133.0 mmHg (127.9 to 138.1) and diastolic BP 81.3 mmHg (77.7 to 85.0). Mean change after introduction of dapagliflozin was -1.1% for HbA1c (-1.6 to -0.6, p<0.001), -2.6kg for weight (-4.0 to -1.1, p=0.001), -4.3mmHg for systolic BP(-9.5 to 0.9, p=0.104) and -2.9mmHg for diastolic BP(-6.5 to 0.8, p=0.121).

At 3-6 months follow-up, 10 patients had ceased dapagliflozin.  Reasons included rash (n=1), nausea (n=2), possible candidiasis (n=1),urinary tract infection (n=1),urinary frequency/nocturia (n=3), non-compliance (n=2) and renal impairment (n=2). Euglycaemic ketoacidosis was not observed.  

Conclusions:
Clinically meaningful reductions in HbA1c, weight and, potentially, BP, were observed following the introduction of dapagliflozin. These findings support the use of dapagliflozin as a second-line or third line oral hypoglycaemic agent. Discontinuation occurred in 10% of patients, for various reasons;a similar  rate in real-life as that  reported in clinical trials.

 

  1. Katz A et al. Dapagliflozin: a review of its use in patients with type 2 diabetes Diabetes 2014; 63(Suppl. 1):A284
#adsadea2016