Long-Term Use of Empagliflozin vs. DPP4 Inhibitors Mitigates eGFR Slopes in Patients With Type 2 Diabetes: Real-World Evidence
Abstract
Background: Randomized controlled studies showed that sodium–glucose cotransporter 2 inhibitors (SGLT2i) mitigate kidney function loss in patients with type 2 diabetes (T2D) at high cardiovascular (CV) and kidney risk. However, long-term efficacy studies in general population with T2D are lacking. Methods: In Maccabi Healthcare Services, a large Israeli database (2015-2021), we compared the change in eGFR in patients with T2D who initiated empagliflozin (EMPA) or any SGLT2i, vs dipeptidyl peptidase-4 inhibitor (DPP4i). Treatment arms were propensity score-matched by 96 baseline characteristics. Subjects were followed until death, end of data availability, exposure discontinuation, initiation of the comparator drug, after 5 years, or October 2021. In a previous analysis we showed that compared to DPP4i, EMPA and any SGLT2i reduce the risk of the primary kidney outcome ( ≥ 40% eGFR declined or end-stage kidney disease). In this secondary analysis, we compared the change in eGFR
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Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design.
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