Dapagliflozin (2) – Forxiga®

Diabetes mellitus type 2

Characteristics

Start date 01.01.2018
Resolution 21.06.2018 repealed
INN Dapagliflozin
Brand name Forxiga®
Pharm. company AstraZeneca GmbH
G-BA Procedure ID D-335
ATC code A10BK01 SGLT2 inhibitors (A10BK)
DDD 10 mg O
Therapeutic area Metabolic diseases Diabetes mellitus (DM type 1-2)
Reason for procedure Reassessment: §14 (manufacturer request)
Original resolution: Dapagliflozin (1) (06.06.2013)
Repealed by: Dapagliflozin (4) (19.12.2019)
Specialty ACT change

Subpopulation Indication Comparator
Forxiga® is indicated in adult patients aged 18 years and older with type 2 diabetes mellitus to improve glycaemic control as:Monotherapy - When diet and exercise alone do not adequately control blood glucose in patients in whom the use of metformin is considered inappropriate due to intolerance.Add-on combination therapy - In combination with other blood glucose-lowering medicines, including insulin, when these, together with diet and exercise, do not adequately control blood glucose. Metformin + sulphonylurea (glibenclamide or glimepiride) or metformin + empagliflozin or metformin + liraglutide

Studies and Results

No. of studies
(best subpopulation)
1 (DapaZu)
Study design
(best subpopulation)
H2H vs. ACT (off-label)
Meta analysis
(best subpopulation)
no
ACT change 07.11.2017 – vor Dossiereinreichung,

b) In combination with another blood-glucose-lowering medicinal product (other than insulin; in this case, metformin), if this medicinal product does not adequately control blood glucose levels in conjunction with diet and exercise

  • For patients being treated with dapagliflozin in combination with another blood glucose-lowering medicinal product (other than insulin; in this case, metformin), where this medicinal product, together with diet and exercise, does not adequately control blood glucose, the additional benefit is not proven.
  • Conclusion
    • Overall, the G-BA concludes that the studies submitted for the benefit assessment – DapaZu and D1690C00004 – are not suitable for establishing an additional benefit for dapagliflozin plus metformin compared with the appropriate comparator therapy.
    • In the DapaZu study, the titration regimen for glimepiride used in the control arm does not correspond to an adequate, patient-specific titration in accordance with the recommendations of the guidelines and the information provided in the summary of product characteristics (SmPC).
    • Similarly, the results of the D1690C00004 study cannot be interpreted due to methodological shortcomings.
    • Taken together, the results of the two studies are highly biased due to the study design, and a valid interpretation of the endpoints is not possible. For this reason, the G-BA concludes that for patients treated with dapagliflozin in combination with another blood glucose-lowering medicinal product (other than insulin, in this case metformin) – where this does not adequately control blood glucose levels in conjunction with diet and exercise – additional benefit is not proven compared with the appropriate comparator therapy.

Courtesy translation only, please refer to the German original.

Associated procedures

Dapagliflozin (8) Forxiga® AstraZeneca GmbH Cardiovascular diseases Chronic heart failure with left ventricular ejection fraction LVEF > 40 % 1,270,000–1,400,000 100% Hint for minor additional benefit
Dapagliflozin (7) Forxiga® AstraZeneca GmbH Metabolic diseases Diabetes mellitus Type 2, ≥ 10 years 650–710 100% additional benefit not proven
Dapagliflozin (6) Forxiga® AstraZeneca GmbH Genitourinary system diseases Chronic kidney disease (CKD) 2,520,200–3,409,200 50% Hint for considerable additional benefit
Dapagliflozin (5) Forxiga® AstraZeneca GmbH · Cardiovascular diseases Chronic heart failure (CHF) 2,061,700–2,273,000 100% Hint for considerable additional benefit
Dapagliflozin (4) Forxiga® AstraZeneca GmbH Metabolic diseases Diabetes mellitus type 2 2,108,000 41% Hint for minor additional benefit
Dapagliflozin (3) Forxiga® AstraZeneca GmbH Metabolic diseases Diabetes mellitus type 1 0
19,200
100% Hint for minor additional benefit repealed
Dapagliflozin (2) Forxiga® AstraZeneca GmbH Metabolic diseases Diabetes mellitus type 2 0
468,700
100% additional benefit not proven repealed
Dapagliflozin (1) Forxiga® Bristol-Myers Squibb GmbH & Co. KGaA/ AstraZeneca GmbH Metabolic diseases Diabetes mellitus type 2 0
896,100
100% additional benefit not proven repealed


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