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).

• 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

• 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)