Treatment with empagliflozin, a sodium-glucose co-transporter 2 (SGLT2) inhibitor, was associated with reduced risk of hospitalization for heart failure when compared with use of dipeptidyl peptidase-4 (DPP-4) inhibitors and glucagon-like peptide (GLP)-1 receptor agonists, according to interim analysis of the EMPRISE study. Findings were presented at the American Heart Association Scientific Sessions 2019 in Philadelphia, PA.

The EMPRISE trial was designed to evaluate the first 5 years of empagliflozin use in the US (2014-2019). In the interim analysis, which included 190,000 adults with type 2 diabetes with and without cardiovascular disease, empagliflozin was associated with a 41% reduction in the risk of hospitalization for heart failure vs DPP-4 inhibitors and a 17% reduction vs GLP-1 receptor agonists. As for non-fatal atherosclerotic cardiovascular events, a similar risk was observed when empagliflozin was compared with DPP-4 inhibitors and GLP-1 receptor agonists (14.6 events vs 17.6 events and 14.8 events per 1000 patient years, respectively).

In a second interim analysis (n=45,000), a significant reduction in all-cause hospitalizations, emergency department visits and physician’s office visits was noted with empagliflozin use compared with DPP-4 inhibitors. 

“We are pleased to see the 3-year data for EMPRISE continues to complement findings from the EMPA-REG OUTCOME trial,” said Sherry Martin, MD, vice president, Global Medical Affairs, Lilly. “These new real-world findings are just one part of a broad and comprehensive clinical development program, including a large heart failure program, that explores how [empagliflozin] can improve patient health outcomes and potentially fill treatment gaps for people with cardiorenal metabolic conditions.” 

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The therapeutic effect of empagliflozin in patients with heart failure, with and without diabetes, is being evaluated in several trials. These include the EMPEROR-Reduced, EMPEROR-Preserved, EMPERIAL-Reduced, EMPERIAL-Preserved, EMPULSE, and EMPA-VISION studies.

Empagliflozin (Jardiance; Boehringer Ingelheim and Lilly) is FDA-approved as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus (T2DM) and to reduce the risk of cardiovascular (CV) death in adults with T2DM and established CV disease.

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