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TOPLINE:

Commonly prescribed SGLT2 inhibitors empagliflozin and dapagliflozin demonstrated comparable effectiveness in preventing major cardiovascular and renal events in patients with type 2 diabetes (T2D) without prior cardiovascular or renal disease.

METHODOLOGY:

• Most robust evidence for SGLT2 inhibitors comes from patients with established cardiovascular disease, limiting their applicability to primary prevention in broader T2D populations.
• Researchers directly compared clinical outcomes with empagliflozin vs dapagliflozin in 135,559 patients with T2D from a Korean database, with a focus on the primary prevention of major cardiovascular and renal events; those with prior atherosclerotic cardiovascular disease, heart failure, or advanced kidney disease were excluded.
• The patients had newly initiated empagliflozin or dapagliflozin between January 2014 and December 2021; 48,351 empagliflozin users were propensity score matched to 48,351 dapagliflozin users; the mean age was approximately 53 years for both groups, with around 65% being men.
• The primary outcome was a composite of cardiovascular and renal events, defined as the first occurrence of cardiovascular death, myocardial infarction, stroke, hospitalization for heart failure, or progression to end-stage renal disease; secondary outcomes included major adverse cardiovascular events and individual components of the primary composite outcome.
• The median follow-up duration of this study was 4.4 years.

TAKEAWAY:

• The risk for the primary composite outcome was not different between dapagliflozin and empagliflozin (hazard ratio, 0.98; P = .72), with incidence rates of 5.15 per 1000 person-years for empagliflozin and 5.31 per 1000 person-years for dapagliflozin.
• Secondary outcomes — including major adverse cardiovascular event, cardiovascular death, myocardial infarction, stroke, hospitalization for heart failure, and progression to end-stage renal disease — also showed no significant differences between the two groups.

IN PRACTICE:

“This study may offer timely and clinically relevant real-world evidence to inform clinical practice in the broader [T2D] population at risk for cardiorenal complications, supporting the clinical interchangeability of empagliflozin and dapagliflozin in the context of primary prevention,” the authors wrote.

SOURCE:

The study was led by Sangwoo Park, MD, PhD, Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea. It was published online in Diabetes Research and Clinical Practice.

LIMITATIONS:

The observational design of the study may have introduced potential for selection bias and residual confounding. Key clinical variables, including diabetes duration, A1c, urine albumin-creatinine ratio, left ventricular ejection fraction, lifestyle factors, and medication adherence, were not available in the claims data. Information on the clinical rationale for selecting a specific SGLT2 inhibitor was lacking, which may have influenced treatment allocation and outcomes.

DISCLOSURES:

This study received support from a research grant provided by Yuhan Corporation, Seoul, Republic of Korea. The authors reported having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.