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Ipragliflozin as an add-on therapy in type 2 diabetes mellitus patients: An evidence-based pharmacoeconomics evaluation

  • Hongmei Wang
    Affiliations
    Department of Pharmacy, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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  • Gaoqiong Yao
    Affiliations
    Department of Pharmacy, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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  • Xi Chen
    Affiliations
    Department of Pharmacy, Hebei University of Science and Technology, Hebei, China
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  • Jing Ouyang
    Correspondence
    Corresponding authors at: The First Affiliated Hospital of Chongqing Medical University, No. 1, Youyi Road, Yuanjiagang, Yuzhong District, 400016 Chongqing, China (J. Yang), Chongqing Public Health Medical Center, No. 109, Baoyu Road, Shapingba District, 400036 Chongqing, China (J. Ouyang).
    Affiliations
    Department of Pharmacy, Chongqing Public Health Medical Center, Chongqing, China
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  • Jiadan Yang
    Correspondence
    Corresponding authors at: The First Affiliated Hospital of Chongqing Medical University, No. 1, Youyi Road, Yuanjiagang, Yuzhong District, 400016 Chongqing, China (J. Yang), Chongqing Public Health Medical Center, No. 109, Baoyu Road, Shapingba District, 400036 Chongqing, China (J. Ouyang).
    Affiliations
    Department of Pharmacy, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Published:September 27, 2019DOI:https://doi.org/10.1016/j.diabres.2019.107867

      Highlights

      • Ipragliflozin as an add-on therapy is effective in improving glycaemic control, with added benefits of some reductions in blood pressure, weight and TG levels.
      • Ipragliflozin as an add-on therapy was well tolerated, as neither the incidence of TEAEs nor drug-related TEAEs was significantly increased, and it also didn’t increase risk of urinary tract infections or genital infections.
      • Ipragliflozin as an add-on therapy do not appear cost-effective compared with metformin alone, but may be competitive against pioglitazone group and the sitagliptin + metformin group.

      Abstract

      Aim

      To evaluate the efficacy, safety and cost-effectiveness of ipragliflozin as an add-on therapy in patients with type 2 diabetes mellitus (T2DM).

      Methods

      PubMed, EMBASE, the Cochrane Library, Web of Science and four Chinese databases, as well as the ClinicalTrials.gov website were searched from their inception through Jan 2019. Methodological quality was assessed using the Cochrane risk of bias, and meta-analysis was performed using RevMan5.3.

      Results

      A total of 11 randomized controlled trials with 1766 patients were included. Ipragliflozin administered (50 mg) once daily as an add-on therapy to other glucose-lowering medications (metformin, pioglitazone, sulfonylurea, α-glucosidase inhibitor, sitagliptin, insulin) was associated with reductions in hemoglobin A1c (HbA1c) of −0.74% (95% confidence interval (CI) −1.00 to −0.48), fasting plasma glucose (WMD −25.03 mg/dL; 95% CI −32.89 to −17.16), weight, waist circumference, blood pressure, and triglycerides levels. Neither the incidence of treatment-emergent adverse events (TEAEs) (RR 1.08; 95% CI 1.00 to 1.16) nor drug-related TEAEs (RR 1.19; 95% CI 0.93 to 1.54) was significantly increased. However, it was associated with an increased risk of hypoglycemia when added to insulin (RR 1.71; 95% CI 1.13 to 2.61). Compared with the pioglitazone group and the sitagliptin + metformin group, the incremental cost-effectiveness ratio of ipragliflozin add-on therapy group was $4976.89, $2089.76 per percentage of qualified HbA1c, respectively.

      Conclusion

      Ipragliflozin as an add-on therapy is well tolerated and effective. Ipragliflozin as an add-on therapy do not appear cost-effective compared with metformin alone, but may be competitive against pioglitazone group and the sitagliptin + metformin group.

      Keywords

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