Dr. Robert J Chilton, MD, argues that new diabetes treatments showing cardiovascular benefit require a different role of the cardiologist. The SGLT2 inhibitor empagliflozin, for example, shows both cardiovascular and renal protection, in addition to lowering glucose.
In diabetic patients at high cardiovascular risk, empagliflozin, when compared with placebo, was not associated with either a reduction or an increase in the risk of cerebrovascular events.
SGLT2 inhibitor dapagliflozin consistently reduced blood pressure, body weight and albuminuria, independently of baseline renal function.
The clinical phase III trial EMPEROR HF is initiated and evaluates CV death and hospitalisation for heart failure with empagliflozin in ~7 000 HFrEF and HFpEF patients with or without diabetes
ACC 2017 In a large real-world study, treatment with SGLT-2 inhibitors versus other glucose-lowering drugs was associated with significant reductions in HF hospitalisation and all-cause death in diabetic patients.
Canagliflozin had beneficial effects on body weight, BMI, waist circumference, SBP, DBP and HDL-C compared with glimepiride or sitagliptin in T2DM patients with metabolic syndrome.
Based on EMPA-REG OUTCOME data, the European Commission has for the first time approved an agent against type 2 diabetes, empagliflozin, to both lower blood glucose and the risk of CV events.
Dr. Jorge Plutzky, MD, discusses the ability to modulate and modify CV risk with new antidiabetic agents. The use of an SGLT2 inhibitor or a GLP1 agonist should be considered in appropriate patients with diabetes.
The SGLT2 inhibitor empagliflozin is the first type 2 diabetes treatment that receives this additional indication based on the CV survival benefit seen the EMPA-REG OUTCOME trial.
CSI Rome Manon Slob and Shahnam Sharif extensively discuss the results of the EMPA-REG OUTCOME study, the first outcomes trial with an SGLT2 inhibitor, with Prof. Silvio Inzucchi, including what the results may mean for the management of diabetes.
The SGLT2 inhibitor ertugliflozin, when given in addition to background therapy of sitagliptin and stable metformin therapy, showed greater reductions in HbA1C in patients with T2DM, as compared with placebo, in the VERTIS SITA2 study.
PERSPECTIVE A 5% significance level more than ‘just’ a positive outcome. There are multiple aspects that need to be considered to classsify a clinical trial as positive.