Greater drop in hemoglobin A1c with empagliflozin plus metformin

(HealthDay)—Twenty-four weeks of empagliflozin + metformin correlates with a significantly greater reduction in hemoglobin A1c (HbA1c) compared with once-daily empagliflozin or twice-daily metformin, according to a study published online Aug. 4 in Diabetes Care.

Samy Hadjadj, M.D., Ph.D., from the Centre Hospitalier Universitaire Poitiers in France, and colleagues randomized 1,364 drug-naive patients with type 2 diabetes to empagliflozin + metformin, empagliflozin, or metformin for 24 weeks. The authors examined the change from baseline in HbA1c at week 24.

At week 24, the researchers observed reductions in HbA1c of −1.9 to −2.1 percent with empagliflozin + metformin twice-daily regimens; −1.4 percent with empagliflozin once-daily regimens; and −1.2 to −1.8 percent with metformin twice-daily regimens. Empagliflozin + metformin twice-daily regimens correlated with significantly greater reductions in HbA1c than for empagliflozin once-daily regimens (P < 0.001) and metformin twice-daily regimens (P < 0.01). Compared with metformin twice-daily regimens, empagliflozin + metformin twice-daily regimens correlated with significantly greater weight loss at week 24 (all P < 0.001). Across the groups, adverse event rates were similar.

"Initial combinations of empagliflozin + metformin for 24 weeks significantly reduced HbA1c versus empagliflozin once daily and metformin twice daily, without increased hypoglycemia, reduced weight versus metformin twice daily, and were well tolerated," the authors write.

Several authors disclosed financial ties to pharmaceutical companies, including Boehringer Ingelheim and Eli Lilly, which manufacture empagliflozin and funded the study.