Circulation, Год журнала: 2024, Номер 150(18), С. 1412 - 1415
Опубликована: Окт. 28, 2024
Язык: Английский
JAMA Internal Medicine, Год журнала: 2025, Номер unknown
Опубликована: Янв. 21, 2025
Importance Evidence on cardiovascular benefits and safety of sodium-glucose cotransporter 2 (SGLT-2) inhibitors is mainly from placebo-controlled trials. Therefore, the comparative effectiveness individual SGLT-2 remain unknown. Objective To compare use canagliflozin or dapagliflozin with empagliflozin for a composite outcome (myocardial infarction [MI] stroke), heart failure hospitalization, MI, stroke, all-cause death, outcomes, including diabetic ketoacidosis (DKA), lower-limb amputation, bone fracture, severe urinary tract infection (UTI), genital whether effects differed by dosage disease (CVD) history. Design, Setting, Participants This study using target trial emulation included adults type diabetes (T2D) 3 US claims databases data August 2014 through June 2020. The was conducted 2023 to July 2024, follow-up period up 8 years, analysis completed in 2024. Exposures First dispensing canagliflozin, dapagliflozin, without any during prior 365 days. Main outcomes measures Database-specific models were weighted propensity score matching-weights adjust 129 confounders. Hazard ratios 95% CIs estimated Cox proportional hazards models. HRs pooled across fixed-effect meta-analysis. Results : Across databases, 232 890 patients receiving 881 295 043 identified. Compared initiators, those less likely have diabetes-related conditions history CVD at baseline. For MI/stroke risk, both (HR, 0.98; CI, 0.91-1.05) 0.95; 0.89-1.03) comparable empagliflozin. initiators had higher risk 1.19; 1.02-1.39), particularly low dose 5 mg 1.30; 1.12-1.50). These findings consistent subgroups events, compared empagliflozin, lower infections 0.94; 0.91-0.97) but UTIs 1.13; 1.03-1.24), risks 0.92; 0.89-0.95) DKA 0.78; 0.68-0.90). Conclusions Relevance found that demonstrated clinically effective doses, though low-dose showed reduced benefit hospitalization
Язык: Английский
Процитировано
3
JAMA Internal Medicine, Год журнала: 2025, Номер unknown
Опубликована: Янв. 21, 2025
Importance No large randomized clinical trial has directly compared empagliflozin with dapagliflozin, leaving their comparative effectiveness regarding kidney outcomes unknown. Objective To compare between initiation of vs dapagliflozin in adults type 2 diabetes who were receiving antihyperglycemic treatment. Design, Setting, and Participants This target emulation used nationwide, population-based routinely collected Danish health care data to received treatment June 1, 2014, October 31, 2020. Data analyzed from 2023 August 2024. Persons followed up until an outcome, emigration, death, 6 years, or December 2021, whichever occurred first. Exposure Initiation dapagliflozin. Main Outcomes Measures included acute injury, incident chronic disease (stages G3 G5 stage A2 A3), progression (≥40% decrease estimated glomerular filtration rate baseline). Risks intention-to-treat per-protocol analyses using Aalen-Johansen estimator that adjusted for 56 potential confounders considered death as a competing event. Results A total 32 819 individuals initiated 17 464 (median [IQR] age, 63 [54-71] years; 18 872 female [37.5%]; median rate, 88 [73-104] mL/min/1.73 m ). After weighting, all measured covariates well balanced the groups. In analyses, people exhibited comparable 6-year risks injury (18.2% 18.5%; risk ratio, 0.98; 95% CI, 0.91-1.06), stages (11.8% 12.1%; 0.97; 0.89-1.05), A3 (14.8% 14.3%; 1.04; 0.93-1.15), (5.3% 5.7%; 0.94; 0.56-1.58). The primary supported by corresponding analyses. Conclusions Relevance results this cohort study suggest had long-term outcomes.
Язык: Английский
Процитировано
1
Circulation, Год журнала: 2025, Номер 151(17)
Опубликована: Апрель 28, 2025
Язык: Английский
Процитировано
0
Circulation, Год журнала: 2025, Номер 151(17)
Опубликована: Апрель 28, 2025
Язык: Английский
Процитировано
0
Cureus, Год журнала: 2025, Номер unknown
Опубликована: Май 4, 2025
Sodium-glucose co-transporter-2 (SGLT2) inhibitors have demonstrated significant cardiovascular benefits in patients with type 2 diabetes. However, head-to-head comparisons between dapagliflozin and empagliflozin, two widely prescribed SGLT2 inhibitors, remain limited. This meta-analysis aimed to directly compare the outcomes of these agents We conducted a comprehensive literature search across multiple databases included eight retrospective studies enrolling 280,617 (158,352 receiving empagliflozin 122,265 dapagliflozin). The primary outcome was major adverse events (MACE), secondary including all-cause mortality, myocardial infarction, stroke. Our pooled analysis revealed no difference MACE risk (RR: 1.04; 95% CI: 0.96 1.13). Similarly, differences were observed for mortality 1.05; 1.15), infarction 0.94 1.16), or stroke 1.00; 0.91 1.09). Subgroup analyses by gender, atherosclerotic disease, chronic kidney disease status showed consistent results. heart failure, trend toward reduced 0.90; 0.82 1.00). Despite pharmacokinetic agents, our findings suggest comparable diabetes, potentially enhanced those failure. due lack studies, this finding should be interpreted caution. These results provide valuable insights clinical decision-making when selecting reduction diabetic patients. Further prospective are warranted confirm explore potential mechanistic agents.
Язык: Английский
Процитировано
0
Diabetes Research and Clinical Practice, Год журнала: 2025, Номер 225, С. 112283 - 112283
Опубликована: Май 26, 2025
Язык: Английский
Процитировано
0
Biomedicines, Год журнала: 2024, Номер 12(12), С. 2875 - 2875
Опубликована: Дек. 18, 2024
Diabetes is a chronic metabolic disorder distinguished by persistent hyperglycemia [...]
Язык: Английский
Процитировано
2
Circulation, Год журнала: 2024, Номер 150(18), С. 1412 - 1415
Опубликована: Окт. 28, 2024
Язык: Английский
Процитировано
1