INFLUENCE OF TYPE 2 SODIUM-GLUCOSE CO-TRANSPORTER INHIBITORS (DAPAGLIFLOZIN) ON THE INDICATORS OF TOTAL MORTALITY IN PATIENTS WITH TYPE 2 DIABETES (CARDIA-MOS STUDY, MOSCOW)

Abstract

BACKGROUND: Widespread clinical use of drugs with cardioprotective/nephroprotective properties – particularly sodium-glucose cotransporter type 2 inhibitors (SGLT2i) – is based on results of large-scale international randomised trials. Meanwhile, there are no data demonstrating a potential effect of these drugs on mortality rates in real clinical practice in Russian patients. To address this lacuna, CARDIA-MOS study was conducted on a population of patients with type 2 diabetes (T2D) in Moscow.OBJECTIVE: To study the effect of SGLT2i on total mortality in T2D patients in Moscow.MATERIALS AND METHODS: To evaluate the frequency of different outcomes, two samples of patients were selected according to predetermined criteria: 1) patients who started SGLT2i (dapagliflozin) therapy in 2017; 2) a control group (no SGLT2i administration) matching the dapagliflozin group in terms of key indicators: age, T2D duration, cardiovascular diseases, insulin therapy, HbA1c level.RESULTS: At Phase 1, data of 499 patients who started dapagliflozin treatment in 2017 were analysed against those of the 499 control group patients (n=998). The groups’ baseline characteristics were generally comparable. Pre-study SBP and HbA1c were worse in the dapagliflozin group. The use of dapagliflozin was associated with a 39% reduction in the relative risk of death from all causes (RR 0.614, 95% CI 0.417–0.903, p=0.013), led to a decrease in HbA1c levels by 0.8% (from 8.5 to 7.7%, p<0.001) over the 48-month-long observation.CONCLUSION: The use of dapagliflozin in the treatment of T2D patients can reduce overall mortality and improve glycaemic control.

Keywords

• type 2 diabetes
• dapagliflozin
• sglt2i
• relative risk of death
• cvd
• chf
• ckd