Efficacy and safety of bexagliflozin in patients with type 2 diabetes mellitus: A systematic review and meta-analysis

Diabetes Obes Metab. 2023 Jul;25(7):1794-1802. doi: 10.1111/dom.15051. Epub 2023 Apr 3.

Abstract

Aim: To assess the efficacy of bexagliflozin in reducing glycated haemoglobin (HbA1c) and the occurrence of side effects in patients with type 2 diabetes (T2DM).

Methods: We searched the PubMed, Embase, Cochrane and ClinicalTrials.gov databases for placebo-controlled, randomized clinical trials published up until 15 February 2023. The primary outcome was change in HbA1c. We computed weighted mean differences (WMDs) for continuous outcomes and odds ratios (ORs) for binary endpoints, with 95% confidence intervals (CIs).

Results: A total of six studies and 3111 patients were included, of whom 1951 were prescribed bexagliflozin. Compared with placebo, bexagliflozin significantly reduced HbA1c levels (WMD -0.53%; 95% CI -0.75, -0.31), fasting plasma glucose levels (WMD -1.45 mmol/L; 95% CI -2.32, -0.57), systolic blood pressure (WMD -4.66 mmHg; 95% CI -6.41, -2.92), diastolic blood pressure (WMD -2.12 mmHg; 95% CI -3.94, -0.30), body weight overall (WMD -1.61 kg; 95% CI -2.14, -1.07), and body weight in patients with a body mass index >25 kg/m2 (WMD -2.05 kg; 95% CI -2.78, -1.31). The proportion of patients who achieved HbA1c < 7% was higher in patients who received bexagliflozin as compared with placebo (OR 1.94; 95% CI 1.36-2.78). There were no significant differences between groups regarding side effects such as hypoglycaemia, genital mycotic infection, urinary tract infection, diarrhoea, headache, nausea, polyuria, diabetic ketoacidosis, or all-cause mortality.

Conclusions: In this meta-analysis, the use of bexagliflozin was associated with improved clinical and laboratory measures in patients with T2DM compared with placebo, with a similar profile of side effects. These findings support the efficacy of bexagliflozin in the treatment of T2DM.

Keywords: diabetes mellitus; glycated haemoglobin; sodium-glucose transporter 2 inhibitors; type 2.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Review

MeSH terms

  • Blood Glucose
  • Body Weight
  • Diabetes Mellitus, Type 2* / complications
  • Glycated Hemoglobin
  • Humans
  • Hypoglycemic Agents / adverse effects
  • Sodium-Glucose Transporter 2 Inhibitors* / adverse effects

Substances

  • Hypoglycemic Agents
  • bexagliflozin
  • Glycated Hemoglobin
  • Sodium-Glucose Transporter 2 Inhibitors
  • Blood Glucose