Empagliflozin, Liraglutide Reduce Cardiovascular Mortality Risk

race and ethnicity impact CV health
race and ethnicity impact CV health
Investigators conducted a meta-analysis to compare the efficacy of SGLT2i, DPP-4i, and GLP-1 agonists for reducing cardiovascular outcomes.
The following article is part of conference coverage from the American Diabetes Association’s 78th Scientific Sessions (ADA 2018) in Orlando,Florida. Endocrinology Advisor’s staff will report on medical research and technological advances in diabetes and diabetes education, conducted by experts in the field. Check back for the latest news from ADA 2018.

ORLANDO – Empagliflozin and liraglutide provide the greatest reduction in cardiovascular mortality, and sodium-glucose cotransporter-2 inhibitors (SGLT1i) may provide additional reductions in heart failure rates, according to results presented at the American Diabetes Association’s 78th Scientific Sessions held in Orlando, Florida, June 22-26, 2018.

The study included 236 randomized controlled trials of >12 weeks’ duration that included 176,310 participants with type 2 diabetes and compared drugs in the SGLT1i, dipeptyl peptidase-4 inhibitors (DPP-4i), or glucagon-like peptide-1 agonists (GLP-1a) classes with another included class or control.

The 236 studies included at total of 20 interventions: 6 DPP-4i, 7 GLP-1a, and 7 SGLT2i.

Compared with controls, empagliflozin and liraglutide reduced cardiovascular mortality (relative risk [RR] 0.63; 95% CI, 0.51-0.79; P <.001; and RR 0.79; 95% CI, 0.66-0.93, P =.006, respectively).

Empagliflozin treatment showed the most significant reduction in cardiovascular mortality, reducing fatal cardiovascular events more than 5 other drug types and control, including 2 DPP-4i, 2 GLP-1a, and 1 SGLT2i.

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Compared with control, both empagliflozin and canagliflozin reduced heart failure events compared with control (RR 0.66; 95% CI: 0.51-0.86, and RR 0.70; 95% CI: 0.54-0.90, respectively). However, saxagliptin actually increased heart failure events (RR 1.23; 95% CI, 1.04-1.46).

No drug of any class had an effect on myocardial infarction or stroke rate.

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Roddick AJ, Zheng S. Comparative cardiovascular efficacy of SGLT2 inhibitors, DPP-4 inhibitors, and GLP-1 agonists—a network meta-analysis. Presented at the American Diabetes Association 2018 conference; June 22-26, 2018; Orlando, FL. Poster 427.