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Plasma lipids were also evaluated as exploratory variables. The goal of this study was to estimate the long\u2010term cardiovascular (<jats:styled-content style=\"fixed-case\">CV<\/jats:styled-content>) and microvascular outcomes of dapagliflozin added to the standard of care (<jats:styled-content style=\"fixed-case\">SOC<\/jats:styled-content>) versus <jats:styled-content style=\"fixed-case\">SOC<\/jats:styled-content> using simulation methodology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The Archimedes Model, a validated model of human physiology, diseases and healthcare systems, was used to model a type 2 diabetes mellitus (<jats:styled-content style=\"fixed-case\">T2DM<\/jats:styled-content>) population derived from National Health and Nutrition Examination Survey (<jats:styled-content style=\"fixed-case\">NHANES<\/jats:styled-content>) with <jats:styled-content style=\"fixed-case\">HbA1c<\/jats:styled-content> 7\u201310%, taking a single oral antidiabetic agent [metformin, sulfonylureas <jats:styled-content style=\"fixed-case\">SU<\/jats:styled-content> or thiazolidinedione (<jats:styled-content style=\"fixed-case\">TZD<\/jats:styled-content>)] at the beginning of the trial. A 20\u2010year trial was simulated comparing dapagliflozin 10\u2009mg, given in addition to <jats:styled-content style=\"fixed-case\">SOC<\/jats:styled-content>, with <jats:styled-content style=\"fixed-case\">SOC<\/jats:styled-content> alone. <jats:styled-content style=\"fixed-case\">SOC<\/jats:styled-content> was based on American Diabetes Association (<jats:styled-content style=\"fixed-case\">ADA<\/jats:styled-content>)\/European Association for the Study of Diabetes (<jats:styled-content style=\"fixed-case\">EASD<\/jats:styled-content>) 2012 guidelines and included diet, metformin, <jats:styled-content style=\"fixed-case\">SU<\/jats:styled-content>, <jats:styled-content style=\"fixed-case\">TZD<\/jats:styled-content>, dipeptidyl peptidase\u20104 (<jats:styled-content style=\"fixed-case\">DPP<\/jats:styled-content>\u20104), glucagon\u2010like peptide\u20101 (<jats:styled-content style=\"fixed-case\">GLP<\/jats:styled-content>\u20101), and insulin therapies, with usage levels reflective of those in <jats:styled-content style=\"fixed-case\">NHANES<\/jats:styled-content>. Dapagliflozin effects were derived from phase 3 clinical trial results. End points included <jats:styled-content style=\"fixed-case\">CV<\/jats:styled-content> and microvascular outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Over a 20\u2010year period, patients on dapagliflozin were projected to experience relative reductions in the incidence of myocardial infarction (<jats:styled-content style=\"fixed-case\">MI<\/jats:styled-content>), stroke, <jats:styled-content style=\"fixed-case\">CV<\/jats:styled-content> death, and all\u2010cause death of 13.8, 9.1, 9.6 and 5.0%, respectively, and relative reductions in the incidence of end\u2010stage renal disease (<jats:styled-content style=\"fixed-case\">ESRD<\/jats:styled-content>), foot amputation, and diabetic retinopathy of 18.7, 13.0 and 9.8%, respectively, when compared with <jats:styled-content style=\"fixed-case\">SOC<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>On the basis of simulation results, adding dapagliflozin to currently available treatment options is projected to further decrease the <jats:styled-content style=\"fixed-case\">CV<\/jats:styled-content> and microvascular complications associated with <jats:styled-content style=\"fixed-case\">T2DM<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dom.12261","type":"journal-article","created":{"date-parts":[[2014,1,20]],"date-time":"2014-01-20T10:13:27Z","timestamp":1390212807000},"page":"628-635","source":"Crossref","is-referenced-by-count":86,"title":["Modeling effects of <scp>SGLT<\/scp>\u20102 inhibitor dapagliflozin treatment versus standard diabetes therapy on cardiovascular and microvascular outcomes"],"prefix":"10.1111","volume":"16","author":[{"given":"J.","family":"Dziuba","sequence":"first","affiliation":[{"name":"Department of Science, Archimedes, Inc. 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