Empagliflozin 10mg / Linagliptin 5mg tablets

AimsTo investigate the renal outcomes of dipeptidyl peptidase 4 (DPP-4) inhibitors, glucagon-like peptide-1 (GLP-1) receptor agonists, and sodium-glucose transport protein-2 (SGLT-2) inhibitors in patients with type 2 diabetes mellitus (T2DM) with chronic renal disease (CKD).Materials and methodsPubMed, Embase, Cochrane CENTRAL, and ClinicalTrials.gov were searched through July 2025 for randomized controlled trials with ≥24 weeks of follow-up in patients with T2DM and CKD. Outcomes included composite renal outcome, estimated glomerular filtration rate (eGFR), and urinary albumin-to-creatinine ratio (UACR). A network meta-analysis was conducted, and the certainty of evidence was assessed with the Grading of Recommendations Assessment, Development, and Evaluation used to evaluate evidence certainty (GRADE).ResultsTwenty RCTs enrolling 80,670 participants were included. Compared with placebo, several agents significantly reduced composite renal outcomes, with dapagliflozin 10 mg showing the greatest efficacy (OR 0.55, 95% CI 0.42-0.72; high-certainty evidence), followed by canagliflozin, empagliflozin, efpeglenatide, sotagliflozin 400 mg, semaglutide, and dulaglutide 1.5 mg. Canagliflozin 100-300 mg significantly reduced UACR, whereas dapagliflozin had no effect. None of the novel antidiabetic agents significantly altered eGFR. Certainty of evidence ranged from high for placebo-controlled comparisons to low or very low for indirect estimates.ConclusionsIn patients with T2DM and CKD, SGLT2 inhibitors provide the most consistent renal protection, while GLP-1 receptor agonists offer additional but variable benefits. Dapagliflozin showed the greatest efficacy, and canagliflozin most strongly reduced albuminuria, highlighting meaningful heterogeneity across agents. DPP-4 inhibitors conferred no renal benefit. Overall, evidence from placebo-controlled trials was robust, whereas certainty was lower for indirect estimates, highlighting the need for drug-specific evaluation in clinical practice.

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Introduction: Empagliflozin and linagliptin are two commonly used medications for the management of Type 2 Diabetes Mellitus (T2DM). However, direct comparison of their efficacy and safety profiles remains limited. This study aims to compare efficacy and safety of empagliflozin and linagliptin in T2DM patients. Methods: Systematic review was done according to the PRISMA statements. Searching was conducted among multiple databases with specific keywords. Selection of studies were done by set of inclusion and exclusion criteria. Included studies were appraised using the Cochrane RoB2.0 critical appraisal tools. Analysis was done qualitatively and quantitatively, with assistance of RevMan 5.4. Heterogeneity analysis was done to determine the effects model used. P value of <0.05 was determined as statistical significance. Results: Four studies with low risk of bias and involving 420 subjects were included. Analysis showed that empagliflozin resulted in significantly greater reductions in HbA1c (MD = 0.71%, 95% CI = 0.43–0.99%) and fasting blood glucose (MD = 47.61 mg/dl, 95% CI = 25.57–69.65 mg/dl) compared to linagliptin. In terms of safety, there were no significant differences in the incidence of hypoglycemia (OR = 0.73, 95% CI = 0.38–1.38) or urinary tract infections (OR = 0.68, 95% CI = 0.37–1.25) between the two treatments. Conclusion: Empagliflozin provided better glycemic control over linagliptin among T2DM patients with satisfactory safety profile.

Abstract licence: CC BY 4.0

BackgroundA number of novel antidiabetic drugs have been developed. These drugs include sodium-glucose cotransporter 2 inhibitors (SGLT-2is), glucagon-like peptide-1 receptor agonists (GLP-1RAs), and dipeptidyl peptidase-4 inhibitors (DPP-4is). However, the optimal medication for individuals with type 2 diabetes mellitus (T2DM) and comorbid chronic kidney disease (CKD) has not been established. To this end, this study was conducted to compare specific novel antidiabetic drugs regarding efficacy and safety.MethodsPubMed, Embase, Cochrane Library, and Web of Science databases were searched for publications dated as of July 9, 2025. Cochrane risk of bias tool version 2.0 (RoB 2.0) was applied to measure the quality of the publications, and R 4.2.2 and Stata 15.1 were used to execute a Bayesian network meta-analysis (NMA). Primary outcomes encompassed major adverse cardiovascular events (MACEs), composite renal outcomes, and all-cause mortality (ACM). Secondary outcomes comprised adverse events (AEs), hypoglycemia, and cardiovascular death.ResultsThis NMA incorporated 30 studies, involving 39,844 participants with T2DM and comorbid CKD. The interventions were ranked by performance in various outcomes using the surface under the cumulative ranking curve (SUCRA) values. Sotagliflozin ranked first in reducing MACEs (SUCRA: 90.57%). Empagliflozin ranked first in improving composite renal outcomes (SUCRA: 89.76%) and reducing ACM (SUCRA: 72.38%). Canagliflozin ranked first in reducing AEs (SUCRA: 83.37%). Dapagliflozin + exenatide ranked first in reducing hypoglycemic events (SUCRA: 77.74%). Semaglutide ranked first in reducing cardiovascular mortality (SUCRA: 89.46%).ConclusionNovel antidiabetic drugs offer benefits for patients with T2DM and comorbid CKD. However, the optimal intervention varies for different outcomes. Further clinical studies are anticipated to validate these findings.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD420251146144.

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BackgroundType 2 diabetes mellitus (T2DM) is a known risk factor for dementia, yet the cognitive impact of different glucose-lowering therapies remains unclear. Emerging evidence suggests sodium-glucose cotransporter-2 (SGLT2) inhibitors may confer neuroprotective benefits compared to dipeptidyl peptidase-4 (DPP-4) inhibitors.ObjectiveTo compare the risk of incident dementia among patients with T2DM initiating SGLT2 inhibitors versus DPP-4 inhibitors.MethodsA systematic search of PubMed, Scopus, and the Cochrane Central Register of Controlled Trials was conducted through June 1, 2025. The primary outcome was all-cause dementia. Secondary outcomes included Alzheimer's disease and vascular dementia. Random-effects models were used to pool adjusted hazard ratios (HRs), and subgroup analyses explored heterogeneity by age, sex, and specific SGLT2 agents.ResultsNine retrospective cohort studies encompassing 2,433,086 individuals (601,692 SGLT2i users; 1,831,394 DPP-4i users) met inclusion criteria. SGLT2 inhibitors were associated with a significantly lower risk of all-cause dementia (HR = 0.74; 95% CI: 0.62-0.87), Alzheimer's disease (HR = 0.62; 95% CI: 0.52-0.74), and vascular dementia (HR = 0.54; 95% CI: 0.49-0.60) compared to DPP-4 inhibitors. Subgroup findings were largely consistent across age and sex. Dapagliflozin and empagliflozin showed significant benefit, while canagliflozin did not.ConclusionUse of SGLT2 inhibitors is significantly associated with lower dementia risk compared to DPP-4 inhibitors in patients with T2DM. Prospective trials are warranted to confirm these findings and explore underlying mechanisms.

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Type 2 diabetes mellitus (T2DM) and obesity are growing global health concerns, particularly in older adults who are at higher risk of sarcopenia. While sodium-glucose cotransporter 2 (SGLT2) inhibitors show promise for glycemic control and weight loss, their effects on muscle health remain unclear. We examined the effects of SGLT2 inhibitors on body weight, fat mass, and muscle mass in T2DM patients. We systematically searched the PubMed, Embase, Scopus, and Cochrane databases for relevant randomized controlled trials (RCTs). Three reviewers screened the studies, and two extracted data and assessed their quality. R software was used to evaluate heterogeneity via Cochran's Q and I2 statistics. Eight RCTs (n = 541) were included. SGLT2 inhibitors significantly reduced body weight (standardized mean difference (SMD) = -0.85, p 2 = 0%) and fat mass (SMD = -0.53, p 2 = 51.1%). A small reduction in muscle mass was observed (SMD = -0.35, p 2 = 22.9%), though substantially smaller than fat loss. Subgroup analysis confirmed that fat mass was reduced with dapagliflozin/ipragliflozin (SMD = -0.67, p 2 = 26.4%) and empagliflozin (SMD = -0.53, p 2 = 66.4%). SGLT2 inhibitors effectively reduce body weight primarily through fat loss in older adults. Although muscle mass declined modestly, the predominance of fat loss suggests weight reduction occurs through favorable metabolic changes. Given the slight muscle mass changes and study heterogeneity, careful monitoring in older adults is warranted, and further studies in diverse populations are needed.

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