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269-OR: Empagliflozin on the Risk of Retinopathy in Patients with Type 2 Diabetes—Results from the EMPRISE Study

Helen Tesfaye, P. Htoo, Julie M. Paik, Heidi Zakoul, N. Schmedt, Anouk Déruaz-Luyet, L. Koeneman, D. Wexler et al.

Diabetes, 2023

Abstract

EMPRISE aims to assess the effectiveness and safety of empagliflozin in patients with type 2 diabetes (T2D) in routine care. Within EMPRISE, we investigated two diabetic retinopathy (DR) outcomes among adults with T2D initiating empagliflozin or DPP4 inhibitors (DPP4i) in 2 separate cohorts. Using data from Medicare-fee-for-service and 2 U.S. commercial claims databases (2014-2019), we compared the risk of non-proliferative DR (NPDR) onset (cohort 1) and the risk of DR progression (cohort 2). To evaluate the onset of NPDR, we identified 34,262 1:1 propensity-score matched (PSM) patient pairs without history of any DR (Table). To evaluate DR progression (see Table for definition), we identified 7,839 1:1 PSM patient pairs with history of NPDR and without diagnosis or treatment for advanced DR prior to cohort entry. We estimated pooled HR and RD/1,000 PY with 95% CI adjusting for 143 baseline covariates. Compared to DPP4i, a similar risk of NPDR onset was observed with empagliflozin initiation [HR: 1.05 (0.95, 1.16); RD: 1.52 (-1.61, 4.65)] and a decreased risk of DR progression [HR: 0.77 (0.62, 0.95); RD: -9.49 (-16.90, -2.08)], over a mean follow-up of ~8 months on treatment. In routine care in a broad population of patients with T2D empagliflozin was associated with a lower risk of DR progression in line with direction and magnitude of a similarly defined DR outcome in the EMPA-REG OUTCOME trial.

H.Tesfaye: None. P.T.Htoo: Employee; Johnson & Johnson. J.M.Paik: None.…

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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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