1222-P: Comparative Efficacy of Ertugliflozin (ERTU) vs. Other Sodium-Glucose Cotransporter 2 Inhibitors (SGLT2i): Model-Based Meta-analysis (MBMA) of HbA1c Lowering

Abstract

Background: ERTU is a selective sodium-glucose cotransporter 2 (SGLT2) inhibitor approved for the treatment of adults with type 2 diabetes mellitus (T2DM). As several SGLT2i are commercially available, MBMA of the HbA1c-lowering effect of these drugs was undertaken to assess their comparative effectiveness. Methods: MBMA quantified the time course of dose vs. HbA1c response of SGLT2i and evaluated the impact of covariates including baseline HbA1c, estimated glomerular filtration rate (eGFR) and background diabetes treatment on HbA1c efficacy. Of the 496 randomized controlled trials (RCTs) in the database, 94 RCTs representing >31,000 T2DM patients were with SGLT2i, including 5 RCTs for ERTU. Results: For SGLT2i, there was a 28.7% (95% CI, 24.5 to 33.1%) greater relative HbA1c efficacy for a 1% absolute increase in baseline HbA1c. Additionally, the HbA1c efficacy was 25.0% (17.0 to 34.0%) greater on a diet background alone relative to a background of metformin (or other oral antidiabetic treatment). For every 10 mL/min/1.73m2 decrease in eGFR, there was a 8.80% (5.90 to 11.6%) decrease in HbA1c efficacy. Conclusion: This MBMA allowed an indirect comparison of SGLT2 inhibitor efficacy across trials (Table). Overall, ERTU doses of 5 and 15 mg were of comparable or numerically greater efficacy to other SGLT2i. Disclosure D. Fediuk: Employee; Self; Pfizer Inc. J. Mandema: Consultant; Self; Merck & Co., Inc., Pfizer Inc., Sanofi. K. Sweeney: Employee; Self; Pfizer Inc. S.G. Terra: Employee; Self; Pfizer Inc. V. Sahasrabudhe: Employee; Self; Pfizer Inc. Funding Pfizer Inc.; Merck Sharp & Dohme Corp.