Real world data confirm CV benefits of SGLT-2 inhibitors in diabetic patients
Lower Rates of Hospitalization for Heart Failure and All-Cause Death in New Users of SGLT-2 Inhibitors: The CVD-REAL Study
Presented at ACC.17 by Mikhail KosiborodNews - Mar. 19, 2017
- The rates of HHF were lower in patients on SGLT-2i's compared with oGLDs (HR: 0.61; 95% CI: 0.51-0.73; P<0.001).
- In a sensitivity on-treatment analysis, after adjustment for history of HF or MI or AF, age, gender, frailty, hypertension, obesity/BMI, duration of DM, ACEi or ARB or b-blocker or a-blocker or Ca+-channel blocker or loop diuretic or thiazide diuretic therapy, the rates of HHF were still lower in patients on SGLT-2's compared with oGLDs (HR: 0.61; 95% CI: 0.53-0.69; P<0.001).
- The unadjusted rates of all-cause death also favoured SGLT-2i therapy vs. oGLD (HR: 0.49; 95% CI: 0.41-0.57; P<0.001).
- The unadjusted rates of all-cause death or HHF were lower in patients on SGLT-2's compared with oGLDs (HR: 0.54; 95% CI: 0.48-0.60; P<0.001).
In a large real-world study across six countries and a broad population of T2DM patients, treatment with SGLT-2i versus oGLDs was associated with significant reductions in hospitalisation for HF, all-cause death, and the combined endpoint of HF hospitalization or all-cause death. The observed CV benefits seem to be class-related and, given the broad population of patients with T2DM in general practice, may extrapolate to real world clinical practice. Since the majority (87%) of patients did not have known CV disease, these benefits may extend to those at the lower end of the risk spectrum.
No significant heterogeneity was observed between countries, despite geographic variations in use of SGLT-2i (predominance of canagliflozin in US and dapagliflozin in other countries).
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