Clinical relevance of recent outcome trials with antidiabetic drugs
Abstract
The results of the landmark EMPA-REG OUTCOME trial were presented at the annual meeting of the European Association for the Study of Diabetes in Stockholm in 2015, with simultaneous publication in the New England Journal of Medicine (NEJM).1 Empagliflozin was the first SGLT2 inhibitor to significantly reduce major adverse cardiovascular events (MACE), a composite of cardiovascular death, myocardial infarction, and stroke. The results were driven by a reduction in cardiovascular deaths, associated with a significant reduction in all-cause mortality. A significant reduction in hospitalisation for heart failure was also noted in this study of diabetes subjects with atherosclerotic cardiovascular disease, which prompted cardiologists to initiate dedicated outcome trials of SGLT2 inhibitors in patients with heart failure, including subjects with and without diabetes.The following year the results of LEADER with liraglutide were presented at the annual meeting of the American Diabetes Association (ADA), and reductions in MACE were demonstrated for the first time with a GLP-1 receptor agonist.2 Again, this was powered by reductions in cardiovascular deaths, with a reduction in all-cause mortality, but in contrast to the EMPA-REG OUTCOME trial there was no significant effect on hospitalisation for heart failure.Since then, we have become accustomed to seeing presentations of primary and subgroup data from outcome trials with SGLT2 inhibitors and GLP-1 receptor agonists at…
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