879-P: Cardiorenal Outcomes Associated with the Use of Dapagliflozin Compared with DPP-4 Inhibitors as Add-on Treatment in Uncontrolled DM2 Patients with Failure to Previous Treatment—A Retrospective, Real-Life Evaluation in México

Abstract

Mexico is one of the three countries in Region of Americas with the highest prevalence (14.4%) of DM. We conducted a retrospective study in Mexico and compare Dapagliflozin effect in cardio-renal outcomes and metabolic control compared to DPP4-inhibitors (DPP4i) as added-on therapy in T2DM patients with failure to previous medications. Objectives: Compare proportion of patients achieving HbA1c below 7%, first appearance of eGFR below 60 ml/min, renal replacement therapy, heart failure hospitalization and death by the end of the 156-week observation period from index date. Inclusion Criteria: T2DM subjects ≥18 years old with failure to any previous antidiabetic medication and HbA1c% ≥7 that started Dapa or DPP4i as add-on to other antidiabetic drugs from August 2014 to December 2019. Statistical Methods and Analysis: A propensity score matching model (nearest neighbor algorithm) was used. Results: Of 1800 subjects, 267 met statistical matching criteria. There were no differences in basal characteristics of age, SBP, Creatinine Clearance, but DAPA group had higher basal HbA1c (8.54±1.45 vs 8.16±1.43, p<0.01). Patients in Dapa compared to DPP4i achieved A1c ≤7% in 49.8% vs 20% (p<0.01) by week 156. Creatinine clearance between groups favored DAPA after week 52 (76.07±18.52 vs 86.40±21.27, p<0.01), and persisted through week 156 (68.19±19.4 vs 88.45±19.73, p<0.01). By week 52, Incidental CKD was present in 5.8% of Dapa group and in 14.8% of DPP4i group, p=0.013 (OR 0.607, 95% IC 0.409-0.901), and by week 156 6.5% DAPA vs 27.6% DPP4i, p<0.01 (OR 0.275, 95% IC 0.191-396). There were no differences in HF hospitalizations. Conclusion: In patients with uncontrolled T2DM who have failed to previous antidiabetic therapies, the add-on of dapagliflozin significantly provides reductions of HbA1c, microalbuminuria and reduces the risk of CKD compared to DPP4i add-on. Disclosure D.Espinoza-peralta: None. S.C.Juarez-comboni: Employee; AstraZeneca. A.M.Rodríguez: Employee; AstraZeneca. J.Hernandez-alarcon: None. I.N.Lopez: None. J.Cetina-canto: None. M.E.Búrquez-gonzález: None. P.V.Paul: None. G.A.Bustamante: None. J.Garnica cuellar: None. L.G.Mireles-zavala: None.