Initiation With SGLT-2 Inhibitors vs. Other Glucose-Lowering Drugs



Title: Lower Risk of Heart Failure and Death in Patients Initiated on SGLT-2 Inhibitors Versus Other Glucose-Lowering Drugs: The CVD-REAL Study

Mikhail K. et al.


 

What You Need to Know:

Type 2 diabetes mellitus patients initiated on a sodium-glucose co-transporter-2 inhibitor (SGLT-2i) have a lower risk of hospitalization for heart failure (HHF) and death compared to patients treated with other glucose lowering drugs (oGLDs).

Trial Design:

  • Multinational study utilized medical claims, physician and hospital records, and national registries to assess the risk of HHF and death in patients initiated on an SGLT-2i versus oGLDs
  • Data obtained from the US, Norway, Denmark, Sweden, Germany, and the UK
  • Primary endpoint: HHF
  • Secondary endpoints: all-cause death, composite of HHF or all-cause death
  • No death data was available for Germany

Key Outcomes:

  • 309,056 patients included in HHF analysis (154,528 in each group)
  • 215,622 patients included in death analysis
  • Total exposure time of medications in the SGLT-2i group: 53% for canagliflozin, 42% for dapagliflozin, and 5% for empagliflozin
  • 961 cases of HHF in 190,164 person-years follow up (incidence rate [IR] 0.51/100 person-years)
  • Death occurred in 1334 patients (IR 0.87/100 person-years) and HHF or death occurred in 1983 patients (IR 1.38/100 person-years)
  • GLT-2i use was associated with lower rates of HHF vs oGLDs (HR 0.61; 95% CI: 0.51, 0.73; P<0.001)
  • Lower rate of death seen in patients treated with a SGLT-2i vs oGLDs (HR 0.49; 95% CI: 0.41, 0.57; P<0.001)
  • Use of an SGLT-2i was associated with a lower rate of HHF or death vs oGLDs (HR 0.54; 95% CI: 0.48, 0.60; P<0.001)