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Evaluation Video

Oral Presentation

Session: Diabetes Drugs Are Good for the Heart

Comparative cardiovascular and renal effectiveness of empagliflozin and dapagliflozin: Scandinavian cohort study

Wednesday, August 28, 2024
9:30 AM – 9:45 AM CEST
Location: Room II
Background: The comparative effectiveness of empagliflozin and dapagliflozin, the most frequently prescribed sodium-glucose co-transporter 2 (SGLT2) inhibitors for cardiorenal risk reduction in patients with type 2 diabetes, is uncertain.

Objectives: To assess the comparative cardiovascular and renal effectiveness and safety of empagliflozin vs. dapagliflozin among patients with type 2 diabetes in routine clinical practice.

Methods: Cohort study using data from nationwide registers in Sweden, Denmark and Norway, from June 2014 to June 2021 including 141 065 new users of empagliflozin and 58 306 new users of dapagliflozin. Coprimary outcomes were major cardiovascular events (myocardial infarction, stroke, and cardiovascular death), heart failure (hospitalization or death because of heart failure) and serious renal events (renal replacement therapy, hospitalization for renal events, and death from renal causes). Secondary outcomes were the individual components of the primary outcomes, any cause death and diabetic ketoacidosis. Inverse probability of treatment weighting was used to balance baseline characteristics between groups. Cox-regression was used to estimate adjusted hazard ratios (aHR).

Results: The mean age of the study population was 63 years and 36% were female. Use of empagliflozin vs. dapagliflozin was associated with similar risk of major cardiovascular events (adjusted incidence rate: 15.9 vs. 15.8 events per 1000 person-years; aHR 1.02, [95% CI 0.97-1.08]), heart failure (6.5 vs. 6.3 events per 1000 person-years; aHR 1.05 [0.97-1.14]) and serious renal events (3.7 vs. 4.1 events per 1000 person-years; aHR 0.97 [0.87-1.07]). In secondary outcome analyses, the aHRs for use of empagliflozin vs. dapagliflozin were 1.00 (0.93-1.07) for myocardial infarction, 1.03 (0.95-1.12) for stroke, 1.01 (0.92-1.13) for cardiovascular death, 1.06 (1.00-1.11) for any cause death, 0.77 (0.60-0.99) for renal replacement therapy, 1.20 (0.75-1.93) for renal death, 1.01 (0.90-1.12) for hospitalization for renal events and 1.12 (0.94-1.33) for diabetic ketoacidosis.

Conclusions: Use of empagliflozin and dapagliflozin was associated with similar risk of cardiovascular and renal outcomes, mortality and diabetic ketoacidosis.