Head-to-head comparative effectiveness of empagliflozin versus dapagliflozin and DPP-4 inhibitors on clinical and metabolic outcomes: a nationwide propensity-matched study
Abstract
Abstract This retrospective study compared the clinical and metabolic effectiveness of empagliflozin (EMPA) versus dapagliflozin (DAPA) and dipeptidyl peptidase-4 inhibitors (DPP4i) using real-world data from the Korean National Health Insurance Service (2013–2024). Adults with type 2 diabetes who initiated treatment and maintained it for > 365 days were included. Clinical and metabolic outcomes were analyzed using Cox models and linear mixed models, respectively, following 1:1 propensity score-matching (n = 17,050 per group for EMPA vs. DAPA and EMPA vs. DPP4i).Compared to DAPA, EMPA was associated with lower risks of hypoglycemia (adjusted hazard ratio [aHR] 0.60, 95% CI 0.44–0.82) and all-cause hospitalization (aHR 0.96, 95% CI 0.92–0.99); other outcomes were comparable. Compared to DPP4i, EMPA was associated with significantly lower risks of hospitalization (aHR 0.83, 95% CI 0.80–0.87), kidney events (aHR 0.76, 95% CI 0.66–0.88), hypoglycemia (aHR 0.59, 95% CI 0.42–0.83), and diabetic ketoacidosis (aHR 0.49, 95% CI 0.33–0.75).In conclusion, while EMPA and DAPA showed broadly similar outcomes supporting a class effect, EMPA demonstrated superior benefits over DPP4i in reducing hospitalization and renal events in routine clinical practice.
Read the paper
Related studies
- Strategy for Mitigating DKA Risk in Patients with Type 1 Diabetes on Adjunctive Treatment with SGLT Inhibitors: A STICH Protocol
- Glucoraphanin: a broccoli sprout extract that ameliorates obesity-induced inflammation and insulin resistance
- SGLT2 Inhibitors in Heart Failure: Targeted Metabolomics and Energetic Metabolism
- Mechanisms of blood pressure reduction with sodium-glucose co-transporter 2 (SGLT2) inhibitors
- Sodium-glucose cotransporter inhibitors: beyond glycaemic control
- Decoding the effects of SGLT2 inhibitors on cardiac arrhythmias in heart failure
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.