Annals of African Medicine
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Year : 2022  |  Volume : 21  |  Issue : 1  |  Page : 26-33

Treatment outcomes of graded dose of empagliflozin in type-2 diabetes: A real world study

1 Department of Endocrinology, Center for Endocrinology, Diabetes, Arthritis and Rheumatism Super Speciality Clinics, New Delhi, India
2 Department of Rheumatology, Center for Endocrinology, Diabetes, Arthritis and Rheumatism Super Speciality Clinics, New Delhi, India
3 Department of Endocrinology, Apex Hospital, Rohtak, Haryana, India
4 Department of Endocrinology, Dr. Ram Manohar Lohia Hospital, New Delhi, India
5 Department of Cardiology, Janakpuri Super Speciality Hospital, New Delhi, India

Correspondence Address:
Deep Dutta
Department of Endocrinology, Center for Endocrinology, Diabetes, Arthritis and Rheumatism Super-speciality Clinics, Plot 107 & 108, Sector 12A Dwarka, New Delhi - 110 075
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/aam.aam_69_20

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Background: Costs are important cause of therapeutic noncompliance in type-2 diabetes mellitus (T2DM). Half-tablet empagliflozin (EMPA)-25 mg has lowest monthly cost among all EMPA preparations; data is unavailable on efficacy of half EMPA-25. This study compared real world weight loss and glycaemic outcomes of 10 mg versus 12.5 mg versus 25 mg of EMPA. Methods: Data, retrospectively captured from records of 2 different centresfor patients > 35 years-age having T2DM on EMPA as part of standard pharmacotherapy for T2DM, having > 6 months follow-up data available was analysed. Patients were in 3-groups depending on EMPA dosage: Group 1 on EMPA 10 mg/day (1-tablet EMPA-10), Group-2 on EMPA 12.5 mg/day (half-tablet EMPA-25), and Group 3 on EMPA 25 mg/day (1-tablet EMPA-25). Primary endpoints were glycaemic efficacy and weight-loss. Results: Of 3601 records screened, data from 599 patients (184, 239 and 176 in Group-1, 2 and 3 respectively) was analysed. All 3 groups were comparable with regards to sex, blood pressure, haemoglobin, renal function, medications use. Group-3 were significantly older, had longest diabetes duration, highest HbA1c and lowest body mass index. Glycaemic efficacy was comparable among groups (ΔHbA1c Groups 1-3: −0.9 (−1.9 – 0.0), −1.0 (−1.8 – 0.5) and − 1.0 (−1.5 – 0.22], respectively; P = 0.363). Patients on EMPA 12.5 or 25 mg/d had significantly higher total (−1.4 [−3.0 –0.2] vs. −0.3 [−2.4 – 1.32] kg; P = 0.028) and percent weight-loss (−1.75% [−4.15 – 0.26] vs. −0.44% [−3.11 – 1.39]; P = 0.039), and significantly higherfraction achieving HbA1c < 5.7% (12% vs. 0; P = 0.021), compared to EMPA-10. Conclusion: Half EMPA-25 is the most cost effective way of using EMPA in clinical practice.

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