Drug group | Product | Cardiovascular benefit / patient group | Benefit in chronic kidney disease | Study | |
---|---|---|---|---|---|
Heart | Kidneys | ||||
Biguanides | Metformin | Beneficial / newly diagnosed patient | Yes | UKPDS 1 | UKPDS1 |
SGLT2 inhibitors | Empagliflozin | Beneficial / secondary prevention | Yes | EMPA-REG 2 | EMPA-REG OUTCOME3 |
Canagliflozin | Beneficial / secondary prevention | Yes | CANVAS4 | CREDENCE5 | |
Dapagliflozin | No benefit / primary and secondary prevention | Yes | DECLARE-TIMI 586 | DAPA-CKD7 | |
Ertugliflozin | No benefit / secondary prevention | VERTIS8 | |||
GLP-1 analogues | Liraglutide | Beneficial / secondary prevention | Yes | LEADER 9 | LEADER9 |
Semaglutide s.c. | Beneficial / secondary prevention | Yes | SUSTAIN-6 10 | SUSTAIN-610 | |
Semaglutide tbl | Possibly beneficial / secondary prevention | PIONEER-6 11 | |||
Dulaglutide | Beneficial / secondary prevention | Yes | REWIND12 | REWIND12 | |
Albiglutide | Beneficial / secondary prevention | HARMONY13 | |||
Lixisenatide | No effect / secondary prevention | Yes (albuminuria) | ELIXA 14 | ELIXA14 | |
Glitazones | Pioglitazone | Beneficial in patients with stroke or TIA | IRIS 15 | ||
No benefit / secondary prevention | PROACTIVE 16 | ||||
Insulin | Insulin | Beneficial / newly diagnosed patient | Yes | UKPDS 17 | UKPDS |
Sulphonylureas | Glibenclamide or glipizide | Beneficial / newly diagnosed patient | Yes | UKPDS 2 | UKPDS17 |
Gliptins | Saxagliptin | No effect / secondary prevention | Possibly harmful | SAVOR-TIMI 18 | |
Sitagliptin | No effect / secondary prevention | No effect | TECOS 19 | TECOS19 | |
Alogliptin | No effect / secondary prevention | No effect | EXAMINE 20 | EXAMINE20 | |
Linagliptin | No effect / secondary prevention | No effect | CARMELINA 22 | CARMELINA21 |
Product | Regular maintenance dose | Number of doses | Reduction in HbA1c1) , mmol/mol (percentage units) | Weight change2) | Hypoglycaemias |
---|---|---|---|---|---|
1) Average reduction in different trials, baseline HbA1c approximately 64 mmol/mol (8.0%) 2) Weight change not taking into account the weight gain occurring as a result of correcting the hyperglycaemia, characteristic of all drugs, except SGLT2 inhibitors. | |||||
Biguanides | |||||
Metformin | 2 000 mg | Twice daily | 15 (1.5) | No change | None |
SGLT2 inhibitors (glucose reabsorption inhibitors) | |||||
Empagliflozin | 10-25 mg | Once daily | 6 (0.6) | Slight decrease (-0.8 kg) | None |
Dapagliflozin | 10 mg | Once daily | 6 (0.6) | Slight decrease (-2.0 kg) | None |
Canagliflozin | 100-300 mg | Once daily | 6 (0.6) | Slight decrease (-1.6 kg) | None |
Ertugliflozin | 5-15 mg | Once daily | 5 (0.5) | Slight decrease (-2.0 - -2.4 kg) | None |
GLP-1 analogues | |||||
Liraglutide s.c. | 1.8 mg | Once daily | 4 (0.4) | Slight decrease (-2.3 kg) | None |
Semaglutide s.c. | 0.5-1.0 mg | Once a week | 7-10 (0.7-1.0) | Slight decrease (-2.9 - -4.3 kg) | None |
Semaglutide tbl | 14 mg | Once daily | 7 (0.7) | Slight decrease (-3.4 kg) | None |
Dulaglutide s.c. | 1.5 mg | Once a week | 6 (0.6) | Slight decrease (-1.5 kg) | None |
Lixisenatide s.c. | 20 µg | Once daily | 4 (0.4) | Slight decrease (-0.4 kg) | None |
Insulin sensitizers (glitazones) | |||||
Pioglitazone | 15-45 mg | Once daily | 10-15 (1.0-1.5) | Slight increase (3.6-4.0 kg) | None |
Enhancers of insulin secretion | |||||
Sulphonylureas | |||||
Glimepiride | 4-6 mg | Once daily | 10-15 (1.0-1.5) | Slight increase | + |
Glibenclamide | 10.5-14 mg | Twice daily | 10-15 (1.0-1.5) | Slight increase | ++ |
Glipizide | 10-15 mg | Twice daily | 10 (1.0) | Slight increase | + |
Glinides (phenylalanine derivatives) | |||||
Repaglinide | 12 mg | 3 times daily | 10 (1.0 ) | Slight increase | + |
DPP-4 inhibitors | |||||
Alogliptin | 25 mg | Once daily | 6 (0.6) | None | None |
Linagliptin | 5 mg | Once daily | 6 (0.6) | None | None |
Saxagliptin | 5 mg | Once daily | 6 (0.6) | None | None |
Sitagliptin | 100 mg | Once daily | 6 (0.6) | None | None |
Vildagliptin | 50 mg | Twice daily | 6 (0.6) | None | None |