Treatment with empagliflozin, a sodium-glucose co-transporter 2 (SGLT2) inhibitor, was associated with a reduced risk of hospitalization for heart failure when compared with dipeptidyl peptidase-4 (DPP-4) inhibitors or glucagon-like peptide 1 (GLP-1) receptor agonists, according to findings from a real-world study.

The EMPRISE study (ClinicalTrials.gov Identifier: NCT03363464) assessed the efficacy and safety of empagliflozin use in approximately 500,000 adults with type 2 diabetes, with and without cardiovascular disease in the US, between 2014 and 2019. The first analysis compared empagliflozin with DPP-4 inhibitors in more than 230,000 adults (115,116 in each treatment arm); the second analysis compared empagliflozin with GLP-1 receptor agonists in more than 260,000 adults (130,408 in each treatment arm). 

Compared with DPP-4 inhibitors, treatment with empagliflozin reduced the relative risk of hospitalization for heart failure by 50% and was associated with a 12% reduction in the risk of the composite outcome of myocardial infarction or stroke, in addition to a decreased relative risk of acute kidney injury. Among patients with Medicare, empagliflozin was associated with a 40% reduction in relative risk of all-cause mortality vs DPP-4 inhibitors.

In the second analysis, empagliflozin decreased the relative risk of hospitalization for heart failure by 30% vs GLP-1 receptor agonists. Similar risks of myocardial infarction, stroke and all-cause mortality were observed in both treatment arms; the results were consistent for patients with and without cardiovascular disease.

“These five-year results from EMPRISE, showing empagliflozin was associated with a decreased risk of hospitalization for heart failure and for death, are encouraging data for adults with type 2 diabetes and their care team,” said Elisabetta Patorno, MD, DrPH, Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women’s Hospital and associate professor of medicine, Harvard Medical School, and study co-investigator.

Empagliflozin is marketed under the brand name Jardiance® as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus; to reduce the risk of cardiovascular death and hospitalization for heart failure in adults with heart failure; and to reduce the risk of cardiovascular death in adults with type 2 diabetes mellitus and established cardiovascular disease.

Reference

Jardiance® decreased relative risk of hospitalization for heart failure by 50% versus DPP-4 inhibitors and by 30% versus GLP-1 receptor agonists in adults with type 2 diabetes in real-world evidence study. News release. Eli Lilly and Company. Accessed June 6, 2022. https://www.prnewswire.com/news-releases/jardiance-decreased-relative-risk-of-hospitalization-for-heart-failure-by-50-versus-dpp-4-inhibitors-and-by-30-versus-glp-1-receptor-agonists-in-adults-with-type-2-diabetes-in-real-world-evidence-study-301561303.html