Variation in Glycemic and Extra Glycemic Parameters with Initiation of Remogliflozin Etabonate in Patients of T2DM Having a Good Glycemic Control with other SGLT2 Inhibitors

Introduction: Remogliflozin etabonate is the latest addition to the Sodium glucose co-transporter-2 (SGLT2) inhibitor class of drugs which is a potent and selective inhibitor of SGLT2.A real world non-randomized, single centre, retrospective study was done to assess changes in glycemic and extra glycemic parameters of type 2 diabetes mellitus (T2DM) patients who were well controlled (HbA1c ≤ 7%) with other SGLT2 inhibitors (Dapagliflozin and Empagliflozin), but had difficulty to afford the high cost of therapy from out of pocket expenditure and voluntarily requested for a switchover for economic reasons. Materials and methods:Retrospective observation of the variations in glycemic and extra glycemic parameters including blood pressure, body weight, lipid profile and eGFR of 32 patients was recorded, when they were initiated on Remogliflozin etabonate, replacing other SGLT2 inhibitors (19 were on Empagliflozin and 13 were on Dapagliflozin).The data was tabulated for a total of three visits (First -initial, Second -at three months from initial and Third-at six months from initial), after which analysis was done.Results: There were no significant changes in HbA1c value from baseline after initiation of remogliflozin etabonate from dapagliflozin and empagliflozin.There was also no significant reduction of blood pressure, body weight and eGFR from baseline for patients switched from Dapagliflozin.However, the change in blood pressure and body weight was statistically significant for patients switched from Empagliflozin (p<0.01).Conclusion: Remogliflozin etabonate given as 100 mg twice daily is non-inferior to Empagliflozin 10 mg / Dapagliflozin 10 mg given as once daily to patients of T2DM as far as their glycemic goals are concerned with favourable extra glycemic benefit and cost burden reduction of more than 50%.