Comparing the Efficacy and Safety of SGLT2 Inhibitors vs DPP4 Inhibitors as Monotherapy or Add-on to Metformin: A Systematic Review and Meta-Analysis

August 10, 2017. Sodium-glucose cotransporter-2 (SGLT-2) inhibitors and dipeptidyl peptidase-4 (DPP-4) inhibitors are both indicated as monotherapy or add-on to metformin for patients with type 2 diabetes (T2D). This systematic review and meta-analysis of 25 randomized controlled trials (N=14,619) compared the efficacy and safety of SGLT-2 vs DPP-4 inhibitors in this therapeutic context. Compared with DPP-4 inhibitors, researchers found a significantly stronger reduction in hemoglobin A1C and fasting plasma glucose (FPG) with SGLT2 inhibitor monotherapy and no significant difference in hypoglycemic event risk. When added to metformin, SGLT-2 inhibitors showed a significant reduction in FPG compared with DPP-4 inhibitors, but no significant differences in A1C reduction or hypoglycemic event risk. Investigators concluded that SGLT-2 inhibitors are equally if not more effective than DPP-4 inhibitors in reducing A1C and FPG without increasing hypoglycemia risk in patients with T2D. Read the article abstract here.