Effect of ertugliflozin on glycemic levels, blood pressure and body weight of patients with type 2 diabetes mellitus: a systematic review and meta-analysis

Purpose To conduct a meta-analysis to evaluate the effect of ertugliflozin on long-term hemoglobin A1c (HbA1c), body weight and blood pressure (BP). Methods Online databases available were searched from their inception to February 2020. Randomized controlled trials (RCTs) comparing ertugliflozin to either placebo or an active control drug were included. Data on four efficacy outcomes were extracted, namely: HbA1c, systolic blood pressure (SBP), diastolic blood pressure (DBP) and body weight. Continuous outcomes were pooled using a random-effects model and presented as weighted mean differences (WMDs) and corresponding 95% CIs. Additionally, a subgroup analysis was done to compare two doses of ertugliflozin (5 mg and 15 mg). A sensitivity analysis was also performed by eliminating studies using active drugs as controls. Results From a total of 123 search results, eight studies were included. Compared to the control group, ertugliflozin was associated with a significant decrease in SBP (WMD: -3.64 mmHg, 95% CI [-4.39,-2.90];p < 0.001; I-2 = 0%) and DBP (WMD: -1.13 mmHg, 95% CI [-1.67,-0.60],p < 0.001; I-2 = 0%). Similarly, significant reductions in body weight (WMD: -2.35 kg, 95% CI [-2.94,-1.77];p < 0.001; I-2 = 0%) as well as HbA1c (WMD: -0.41%, 95% CI [-0.62,-0.20]; p < 0.001; I-2 = 0%) were seen with ertugliflozin. Subgroup analysis demonstrated no significant difference in efficacy between the two doses in any of the four outcomes. Conclusion Ertugliflozin results in significant reductions in HbA1c, body weight, SBP and DBP, when compared to control. Subgroup analyses suggest that these effects are not dose-dependent.