Comparison of efficacy between dipeptidyl peptidase-4 inhibitor and sodium–glucose cotransporter 2 inhibitor on metabolic risk factors in Japanese patients with type 2 diabetes mellitus: Results from the CANTABILE study

Cheol Son,Hisashi Makino,Masato Kasahara,Tomohiro Tanaka,Kunihiro Nishimura,S Taneda,Takeshi Nishimura,Shu Kasama,Yoshihiro Ogawa,Yoshihiro Miyamoto,Kiminori Hosoda

doi:10.1016/j.diabres.2021.109037

Abstract

AimsThe aim of this study was to compare the effectiveness of teneligliptin, a dipeptidyl peptidase-4 (DPP-4) inhibitor, and canagliflozin, a sodium–glucose cotransporter 2 (SGLT2) inhibitor, at reducing a composite outcome of three metabolic risk factors (obesity, hypertension, and dyslipidemia) in Japanese patients with type 2 diabetes mellitus (T2DM) and metabolic risks. MethodsIn this prospective, multicenter, open-label, randomized, parallel-group comparison study, 162 patients with T2DM and one or more metabolic risk factors were randomized into a teneligliptin or canagliflozin group and treated for 24 weeks. The primary endpoint was the composite percentage of subjects who experienced an improvement in at least one metabolic risk after 24 weeks of treatment. ResultsThe primary endpoint was achieved significantly by more patients in the canagliflozin group than in the teneligliptin group (62.2% vs. 31.3%, p = 0.0004). A ≥ 3% body weight loss was also achieved by significantly more participants in the canagliflozin group than in the teneligliptin group (55.9% vs. 10.5%, p < 0.0001). ConclusionsThis study showed canagliflozin to be more effective at reducing metabolic risks than teneligliptin. In Japanese patients with T2DM and metabolic risk factors, SGLT2 inhibitors may be superior to DPP-4 inhibitors at controlling multiple metabolic risk.

Highlights

There has been a growth in the number of people affected by diabetes mellitus worldwide over recent years
162 patients were randomized to the teneligliptin group (n = 80) or canagliflozin group (n = 82)
A total of 145 patients were included in the full analysis with 70 in the teneligliptin group and 75 in the canagliflozin group (Fig. 1)

Summary

Introduction

There has been a growth in the number of people affected by diabetes mellitus worldwide over recent years. Type 2 diabetes mellitus (T2DM) is associated with multiple vascular complications, increased mortality, and decreased quality of life [1]. In contrast to studies focusing on intensive glycemic control in isolation, trials of multifactorial interventions based on glycemic, blood pressure, and lipid control have indicated the potential to reduce cardiovascular complications and mortality in patients with T2DM [6,7]. Hypertension, and dyslipidemia are all independent risk factors for T2DM. When these metabolic risk factors are present in a single patient, which is often the case, the risk of cardiovascular events is enhanced synergistically rather than additively [8].

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Results

Conclusion