Autor:innen:
E. Patorno (Boston, MA, US)
A. Pawar (Boston, MA, US)
J. Franklin (Boston, MA, US)
M. Najafzadeh (Boston, MA, US)
D. Wexler (Boston, MA, US)
A. Déruaz-Luyet (Ingelheim, DE)
K. Brodovicz (Ridgefield, US)
L. Bessette (Boston, MA, US)
S. Schneeweiss (Boston, MA, US)
Aims: In EMPA-REG OUTCOME, empagliflozin reduced hospitalisation for heart failure (HHF) by 35%, with a similar incidence of myocardial infarction (MI) and stroke, versus placebo, in patients with type 2 diabetes (T2D) and established atherosclerotic cardiovascular (ASCV) disease. In interim analyses from EMPRISE, which aims to study the effectiveness, safety and healthcare utilisation of empagliflozin in routine care across a broad spectrum of cardiovascular (CV) risk, we evaluated the association between empagliflozin and CV and HHF risk.
Methods: Using two commercial datasets (08/2014-09/2017) and Medicare fee-for-service (08/2014-09/2016), 39,169 pairs of 1:1 propensity score-matched T2D patients aged ≥18 years initiating EMPA or a DPP4 inhibitor (DPP4i), and 55,860 pairs initiating empagliflozin or a GLP1-receptor agonist (GLP1-RA), were identified. We assessed a combined atherosclerotic CV (ASCV) event (MI, stroke, hospitalisation for unstable angina, or coronary revascularisation) and HHF (HF diagnosis in discharge report in the primary [HHF-Specific] or in any position [HHF-Broad]). HRs were estimated adjusting for >140 baseline covariates.
Results: Similar characteristics were observed in both cohorts. Compared to DPP4i, empagliflozin was associated with decreased HHF risk (HHF-Specific: 0.42 [0.31–0.58]; HHF-Broad: 0.59 [0.51–0.69]), and similar risk for an ASCV event (HR [95% CI] 0.88 [0.74–1.03]). Results for empagliflozin vs GLP1-RA were similar: HHF-Specific (0.63 [0.49–0.80]), HHF-Broad (0.83 [0.74–0.93]), and ASCV event (0.99 [0.87–1.13]).
Conclusions: An interim analysis from EMPRISE showed that compared with DPP4i or GLP1-RA, empagliflozin was associated with decreased risk of HHF, and similar risk of ASCV events, in routine clinical care.