Abstract
Real-world effectiveness of remogliflozin versus liraglutide in obese T2DM to evaluate glycemic control and bodyweight
Author(s): Anand Shankar
Objective: Newer AHAs for T2DM, including sodium glucose co-transporter 2 (SGLT2) inhibitors and glucagon-like peptide-1 receptor agonists (GLP1RAs), have been shown to be effective for glycemic control and to promote weight loss, which may contribute to the cardiovascular benefits seen with some of these agents [1,2]. Remogliflozin is the new SGLT2i which has approved in India.
Aim: Real-world effectiveness of remogliflozin 100 mg BD versus liraglutide 0.6 mg/day was examined in obese and uncontrolled patients with Type II diabetes.
Methods: A single center, retrospective observational study conducted for 24 weeks in a real-world setting. Dose of remogliflozin was 100mg BD and liraglutide was 0.6 mg/day. All patients received remogliflozin or liraglutide in addition to their existing antidiabetic therapy except dipeptidyl peptidase-4 inhibitors and insulin. HbA1c, Weight and BMI were evaluated at baseline and after 24 weeks of therapy.
Results: A total of 60 patients with 42 (70%) females, 18 (30%) males, overweight (91.71 ± 14.19 kg), obese (35.6 ± 5.04 kg/m2) and uncontrolled (HbA1c 8.2 ± 0.8%) patients with T2DM. Mean HbA1c and rate of achieving HbA1c<7% was similar at 6 months with remogliflozin (N=45)(P < 0.05) and liraglutide (N=15)(P < 0.05). At 24 weeks, patients who continued liraglutide had a non-significant mean weight loss of 2.73 ±0.62 kg which was 2.69 ± 1.02 kg with remogliflozin and non-significant decrease in BMI was found in both the arm (-1.15 ±0.6 kg/m2 with remogliflozin and -1.21 ±0.8 kg/m2 with liraglutide). Patients were less likely to discontinue or switch with remogliflozin than liraglutide, and were more likely to add-on because of cost effectiveness.
Discussion: There is a progressive decline in β-cell function in T2DM requiring treatment adjustment. Co-morbidities such as obesity, cardiovascular diseases and patient factors like financial capabilities, compliance needs to be taken into consideration while individualizing therapy. Low dose liraglutide (0.6 mg/dl) once a day and remogliflozin 100 mg BD improved glycemic control and decrease in weight in almost similar fashion, in obese uncontrolled longstanding type 2 diabetes. Patients in the remogliflozin compare to liraglutide were more likely to be adherent to treatment and less likely to discontinue or switch treatment.