Reducing HF Hospitalization Risk: Antidiabetic Drug Classes Compared

Heart failure book
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The authors searched for randomized placebo-controlled trials (December 1, 2008 to November 24, 2017) involving 3 pharmacologic classes of antidiabetic medications to compare the effects of these agents on the risk of hospitalization for HF in T2DM patients.

Sodium-glucose co-transporter 2 (SGLT-2) inhibitors appear to be more effective than glucagon-like peptide 1 (GLP-1) agonists or dipeptidyl peptidase 4 (DPP-4) inhibitors for lowering the risk of hospitalization for heart failure (HF) in patients with type 2 diabetes mellitus (T2DM), according to a meta-analysis published in JACC: Heart Failure.

For this study, the authors searched for randomized placebo-controlled trials (December 1, 2008 to November 24, 2017) involving 3 pharmacologic classes of antidiabetic medications to compare the effects of these agents on the risk of hospitalization for HF in T2DM patients. A total of 9 studies involving 87,162 patients were identified.

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Results showed that SGLT-2 inhibitors were associated with the greatest reduction in risk for HF hospitalization compared with placebo (relative risk [RR] 0.56, 95% CI, 0.43–0.72). When compared with GLP-1 agonists (RR 0.59, 95% CI, 0.43–0.79) and DPP-4 inhibitors (RR 0.50, 95% CI, 0.36–0.70), SGLT-2 inhibitors showed a significant risk reduction for HF hospitalization. 

“Ranking of the classes revealed 99.6% probability of SGLT-2 inhibitors being the optimal treatment for reducing the risk of this outcome, followed by GLP-1 agonists (0.27%) and DPP-4 inhibitors (0.1%),” write the authors.

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