Your browser doesn't support javascript.
loading
Cardiorenal effectiveness of empagliflozin vs. glucagon-like peptide-1 receptor agonists: final-year results from the EMPRISE study.
Htoo, Phyo T; Tesfaye, Helen; Schneeweiss, Sebastian; Wexler, Deborah J; Everett, Brendan M; Glynn, Robert J; Schmedt, Niklas; Koeneman, Lisette; Déruaz-Luyet, Anouk; Paik, Julie M; Patorno, Elisabetta.
Afiliación
  • Htoo PT; Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 1620 Tremont Street, Suite 3030, Boston, MA, 02120, USA.
  • Tesfaye H; Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 1620 Tremont Street, Suite 3030, Boston, MA, 02120, USA.
  • Schneeweiss S; Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 1620 Tremont Street, Suite 3030, Boston, MA, 02120, USA.
  • Wexler DJ; Massachusetts General Hospital Diabetes Center, Harvard Medical School, Boston, USA.
  • Everett BM; Divisions of Cardiovascular and Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, USA.
  • Glynn RJ; Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 1620 Tremont Street, Suite 3030, Boston, MA, 02120, USA.
  • Schmedt N; Global Epidemiology, Boehringer Ingelheim International GmbH (Germany) DE, Berlin, Germany.
  • Koeneman L; Global Medical Affairs, Lilly Deutschland GmbH, Bad Homburg, Germany.
  • Déruaz-Luyet A; Global Epidemiology, Boehringer Ingelheim International GmbH (Germany) DE, Berlin, Germany.
  • Paik JM; Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 1620 Tremont Street, Suite 3030, Boston, MA, 02120, USA.
  • Patorno E; Division of Renal (Kidney) Medicine, Brigham and Women's Hospital, Boston, MA, USA.
Cardiovasc Diabetol ; 23(1): 57, 2024 02 08.
Article en En | MEDLINE | ID: mdl-38331813
ABSTRACT

BACKGROUND:

No randomized clinical trials have directly compared the cardiorenal effectiveness of empagliflozin and GLP-1RA agents with demonstrated cardioprotective effects in patients with a broad spectrum of cardiovascular risk. We reported the final-year results of the EMPRISE study, a monitoring program designed to evaluate the cardiorenal effectiveness of empagliflozin across broad patient subgroups.

METHODS:

We identified patients ≥ 18 years old with type 2 diabetes who initiated empagliflozin or GLP-1RA from 2014 to 2019 using US Medicare and commercial claims databases. After 11 propensity score matching using 143 baseline characteristics, we evaluated risks of outcomes including myocardial infarction (MI) or stroke, hospitalization for heart failure (HHF), major adverse cardiovascular events (MACE - MI, stroke, or cardiovascular mortality), a composite of HHF or cardiovascular mortality, and progression to end-stage kidney disease (ESKD) (in patients with chronic kidney disease stages 3-4). We estimated hazard ratios (HR) and rate differences (RD) per 1,000 person-years, overall and within subgroups of age, sex, baseline atherosclerotic cardiovascular disease (ASCVD), and heart failure (HF).

RESULTS:

We identified 141,541 matched pairs. Compared with GLP-1RA, empagliflozin was associated with similar risks of MI or stroke [HR 0.99 (0.92, 1.07); RD -0.23 (-1.25, 0.79)], and lower risks of HHF [HR 0.50 (0.44, 0.56); RD -2.28 (-2.98, -1.59)], MACE [HR 0.90 (0.82, 0.99); RD -2.54 (-4.76, -0.32)], cardiovascular mortality or HHF [HR 0.77 (0.69, 0.86); RD -4.11 (-5.95, -2.29)], and ESKD [0.75 (0.60, 0.94); RD -6.77 (-11.97, -1.61)]. Absolute risk reductions were larger in older patients and in those with baseline ASCVD/HF. They did not differ by sex.

CONCLUSIONS:

The cardiovascular benefits of empagliflozin vs. cardioprotective GLP-1RA agents were larger in older patients and in patients with history of ASCVD or HF, while they did not differ by sex. In patients with advanced CKD, empagliflozin was associated with risk reductions of progression to ESKD.
Asunto(s)
Palabras clave
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Compuestos de Bencidrilo / Enfermedades Cardiovasculares / Accidente Cerebrovascular / Diabetes Mellitus Tipo 2 / Aterosclerosis / Inhibidores del Cotransportador de Sodio-Glucosa 2 / Glucósidos / Insuficiencia Cardíaca Tipo de estudio: Clinical_trials / Diagnostic_studies / Prognostic_studies Límite: Adolescent / Aged / Humans País/Región como asunto: America do norte Idioma: En Revista: Cardiovasc Diabetol Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA / ENDOCRINOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Compuestos de Bencidrilo / Enfermedades Cardiovasculares / Accidente Cerebrovascular / Diabetes Mellitus Tipo 2 / Aterosclerosis / Inhibidores del Cotransportador de Sodio-Glucosa 2 / Glucósidos / Insuficiencia Cardíaca Tipo de estudio: Clinical_trials / Diagnostic_studies / Prognostic_studies Límite: Adolescent / Aged / Humans País/Región como asunto: America do norte Idioma: En Revista: Cardiovasc Diabetol Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA / ENDOCRINOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido