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  • Real-world data from CVD-REAL 2 demonstrates SGLT2 inhibitors benefits over DPP-4 inhibitors for CV risk reduction

Real-world data from CVD-REAL 2 demonstrates SGLT2 inhibitors benefits over DPP-4 inhibitors for CV risk reduction

Real-world data from CVD-REAL 2 demonstrates SGLT2 inhibitors benefits over DPP-4 inhibitors for CV risk reduction

First study to compare SGLT2 inhibitors with DPP-4 inhibitors for a broad range of cardiovascular (CV) outcomes shows that risk of CV events and death in adult patients with type 2 diabetes is lower in those newly initiated with SGLT2 inhibitors compared with those newly initiated on DPP-4 inhibitors.

In this comparative cohort analysis of the CVD-REAL 2 Multinational Cohort Study, health records from 13 countries and 4 major geographical regions (Asia-Pacific, Middle East, Europe and North America) were used. Following propensity score matching, 193,124 new users of SGLT2 inhibitors and 193,124 new users of DPP-4 inhibitors were included in the study population.

Initiation of SGLT2 inhibitors versus DPP-4 inhibitors, after a median follow-up of 1.2 years, demonstrated substantially lower risk of:

  • Hospitalisation for heart failure (hazard ratio [HR]: 0.69, 95% confidence interval [CI]: 0.61-0.77; P<0.0001)
  • All-cause death (HR: 0.59, CI: 0.52-0.67; P<0.0001)
  • Composite of hospitalisation for heart failure or all-cause death (HR: 0.64, CI: 0.57-0.72; P<0.0001)
  • Myocardial infarction (HR: 0.88, CI: 0.80-0.98; P = 0.020)
  • Stroke (HR: 0.85, CI: 0.77-0.93; P = 0.0004)

Additionally, in the subset of patients without established CV disease (69.9%), SGLT2 inhibitors when compared with DPP-4 inhibitors also demonstrated significantly lower risks of CV outcomes. These results imply the CV benefits of SGLT2 inhibitors over DPP-4 inhibitors can be seen in both higher and lower CV risk populations.

Adding to the wealth of evidence of CV outcomes in SGLT2 clinical trials, these findings provide real-world evidence for the CV benefits of SGLT2 inhibitors compared with DPP4 inhibitors.

 

"All this evidence makes us wonder why DPP-4 inhibitors are still being prescribed more than SGLT-2 inhibitors all over the world, despite clear differences in cardiovascular and renal benefits and similar cost"

Dr. Gorgojo

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Editorial Board

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Dr. Salvatore A. De Cosmo's image

Dr. Salvatore A. De Cosmo

Head of Unit of Internal Medicine and Endocrinology, Scientific Institute “Casa Sollievo della Sofferenza” San Giovanni, Rotondo, Italy
,
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Dr. Juan José Gorgojo Martínez's image

Dr. Juan José Gorgojo Martínez

Head of Department of Endocrinology and Nutrition, University Hospital Fundación, Alcorcon, Madrid, Spain
,
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Dr. Patrick Holmes' image

Dr. Patrick Holmes

General Practitioner, St. George's Medical Practice, Darlington, UK

Editorial Board

Image
Dr. Salvatore A. De Cosmo's image

Dr. Salvatore A. De Cosmo

Head of Unit of Internal Medicine and Endocrinology, Scientific Institute “Casa Sollievo della Sofferenza” San Giovanni, Rotondo, Italy
Image
Dr. Juan José Gorgojo Martínez's image

Dr. Juan José Gorgojo Martínez

Head of Department of Endocrinology and Nutrition, University Hospital Fundación, Alcorcon, Madrid, Spain
Image
Dr. Patrick Holmes' image

Dr. Patrick Holmes

General Practitioner, St. George's Medical Practice, Darlington, UK

Publication under Spotlight

Risk of Cardiovascular Events and Death Associated With Initiation of SGLT2 Inhibitors Compared With DPP-4 Inhibitors: an Analysis From the CVD-REAL 2 Multinational Cohort Study

Lancet Diabetes Endocrinol
2020;8(7):606-615.

Authors: Shun Kohsaka, Carolyn S P Lam, Dae Jung Kim, Matthew A Cavender, Anna Norhammar, Marit E Jørgensen, Kåre I Birkeland, Reinhard W Holl, Josep Franch-Nadal, Navdeep Tangri, Jonathan E Shaw, JenniIlomäki, Avraham Karasik, Su-Yen Goh, Chern-En Chiang, Marcus Thuresson, Hungta Chen, Eric Wittbrodt, Johan Bodegård, Filip Surmont, Peter Fenici, Mikhail Kosiborod

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