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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Article info
Publication history
Published online: September 27, 2019
Accepted:
September 23,
2019
Received in revised form:
September 8,
2019
Received:
April 13,
2019
Identification
Copyright
© 2019 Elsevier B.V. All rights reserved.
