Cardiorenal outcomes of empagliflozin versus dapagliflozin in primary prevention among patients with type 2 diabetes: A nationwide cohort study
Abstract
AIMS
While both empagliflozin and dapagliflozin have demonstrated cardiorenal benefits in patients with type 2 diabetes, their comparative effectiveness in patients without established cardiovascular or renal disease remains uncertain.
METHODS
Using the Korean National Health Insurance Service database, we identified patients with type 2 diabetes who newly initiated either empagliflozin or dapagliflozin and had no prior history of established cardiovascular or renal disease. The primary outcome was defined as the first occurrence of cardiovascular death, myocardial infarction, stroke, hospitalization for heart failure, or progression to end-stage renal disease. The secondary outcomes were major adverse cardiovascular event and individual components of the primary outcome.
RESULTS
A total of 135,559 new users of dapagliflozin or empagliflozin were identified. After 1:1 propensity score matching, the risk of the primary outcome was not different significantly between dapagliflozin and empagliflozin (hazard ratio 0.98, 95% confidence interval 0.89-1.09). The risks of secondary outcomes were also comparable. The overall findings were consistent across the several sensitivity analyses.
CONCLUSIONS
This nationwide cohort study, empagliflozin and dapagliflozin showed similar effectiveness in preventing cardiorenal outcomes among patients with type 2 diabetes without established cardiovascular or renal disease, supporting their clinical interchangeability for primary prevention in…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.
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