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Efficacy and safety of empagliflozin for type 2 diabetes: a systematic review and meta‐analysis
Author(s) -
Liakos A.,
Karagiannis T.,
Athanasiadou E.,
Sarigianni M.,
Mainou M.,
Papatheodorou K.,
Bekiari E.,
Tsapas A.
Publication year - 2014
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1111/dom.12307
Subject(s) - empagliflozin , medicine , placebo , cochrane library , type 2 diabetes , metformin , meta analysis , confidence interval , odds ratio , diabetes mellitus , dapagliflozin , randomized controlled trial , endocrinology , insulin , alternative medicine , pathology
Aim To assess the efficacy and safety of the novel sodium‐glucose cotransporter 2 (SGLT2) inhibitor empagliflozin compared with placebo or other antidiabetic agents in patients with type 2 diabetes. Methods We conducted a systematic review and meta‐analysis of randomized controlled trials. We searched Medline, Embase and the Cochrane Library through December 2013 and grey literature. Two reviewers working independently extracted relevant data and carried out risk‐of‐bias assessments. We synthesized results using random‐effects models and computed weighted mean differences (WMDs) and odds ratios (ORs). Results We included 10 studies with 6203 participants. Compared with placebo, mean changes in haemoglobin A1c were −0.62% [95% confidence interval (CI) −0.68 to −0.57%] for empagliflozin 10 mg and −0.66% (−0.76 to −0.57%) for empagliflozin 25 mg. Empagliflozin 25 mg daily had glycaemic efficacy similar to metformin or sitagliptin (WMD −0.11%; 95% CI −0.25 to 0.03%), without increasing risk for hypoglycaemia. It was also associated with body weight loss (WMD −1.84; 95% CI −2.30 to −1.38 kg vs. placebo) and had a favourable effect on blood pressure. Incidence of hypoglycaemia with empagliflozin was similar to placebo (OR 1.10; 95% CI 0.87 to 1.39); nevertheless we noted an increased risk for genital tract infections (OR 3.31; 95% CI 1.55 to 7.09). Findings were similar for the 10‐mg dosing regimen. Conclusions Empagliflozin effectively lowers blood glucose and provides additional clinical benefits including body weight and blood pressure reduction. Ongoing trials will elucidate the long‐term safety and effect of empagliflozin on cardiovascular outcomes.