Empagliflozin Cuts Risk of Hospitalization for Heart Failure for Adults With Type 2 Diabetes

Jardiance shows a reduction of 50% compared to dipeptidyl peptidase-4 inhibitors and 30% compared to glucagon-like peptide 1 receptor agonists.

Empagliflozin (Jardiance; Boehringer Ingelheim, Eli Lilly and Company) was associated with a reduction in the risk of hospitalization for heart failure compared with 2 other classes of glucose-lowering therapies in adults with type 2 diabetes in routine care, according to 2 analyzes of the EMPRISE real-world study.

“Heart failure is present in up to 30% of all people with type 2 diabetes, so it is critical that healthcare professionals treating this population receive treatments that demonstrate cardiovascular effectiveness in routine care,” Elisabetta Patorno, MD, DrPH, from the division of pharmacoepidemiology and pharmacoeconomics at Brigham and Women’s Hospital and an associate professor of medicine at Harvard Medical School, in a statement. “These 5-year results from EMPRISE, showing that empagliflozin was associated with a reduced risk of hospitalization for heart failure and death, are encouraging data for adults with type 2 diabetes and their healthcare team.”

Relative risk reductions were 50% with empagliflozin compared to dipeptidyl peptidase-4 (DPP-4) inhibitors and 30% compared to glucagon-like peptide 1 (GLP-1) receptor agonists.

The results were presented at the American Diabetes Association Scientific Sessions 2022 in New Orleans, Louisiana.

Compared to DPP-4 inhibitors, empagliflozin was also associated with a 40% reduction in the relative risk of all-cause mortality in subjects receiving Medicare. In the overall population in the study, empagliflozin was associated with a 12% reduction in the risk of composite outcomes of myocardial infarction or stroke compared to DPP-4 inhibitors.

Furthermore, compared to GLP-1 receptor agonists, empagliflozin was associated with a similar risk of all-cause mortality, heart attack and stroke. All results for empagliflozin compared to GLP-1 receptor agnostic, and specifically liraglutide, were consistent for individuals with and without cardiovascular disease.

“We are pleased that this analysis of EMPRISE has shown that, compared to other drugs, Jardiance can reduce the need for hospitalization for heart failure, as well as the overall number of deaths in people with type 2 diabetes. This is welcome data for the 60 million people living with cardio-metabolic disorders worldwide,” Waheed Jamal, MD, corporate vice president and chief of CardioMetabolic Medicine at Boehringer Ingelheim, said in the statement.

The results of the EMPRISE real-world study, which assessed the first 5 years of use with empagliflozin in the United States, complement previously reported data from the landmark EMPA-REG OUTCOME trial, which showed that empagliflozin had a relative risk reduction of 35% had hospitalization for heart failure compared to placebo in adults with type 2 diabetes and established cardiovascular disease. In addition, the study showed a 38% relative risk reduction in cardiovascular death with empagliflozin compared to placebo.

The findings of the EMPRISE confirmed the established safety profile of empagliflozin. Compared to DPP-4 inhibitors, empagliflozin was associated with a reduction in the relative risk of acute renal injury. There was an increase in the relative risk of hospitalization for diabetic ketoacidosis, which is consistent with the known safety profile of empagliflozin.

In addition, the risks for bladder and kidney cancer, fractures and amputations of the lower extremities were similar.

The EMPRISE study in the United States involved nearly 500,000 individuals in real care settings, according to researchers.

Reference

Real-world evidence shows benefits for heart failure. Boehringer Ingelheim. news item. June 6, 2022. Accessed June 9, 2022. https://www.boehringer-ingelheim.com/human-health/metabolic-diseases/diabetes/emprise-study

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