- Compared with sitagliptin (Januvia), initiation of empagliflozin (Jardiance) is associated with decreased risk for heart failure (HF) hospitalization (HHF) among patients with type 2 diabetes (T2D), with or without cardiovascular disease (CVD) history, treated in routine care.
Why this matters
- Preliminary real-world data support EMPA-REG OUTCOME clinical trial findings.
- Propensity score-matched cohorts of patients with T2D initiating empagliflozin or sitagliptin with 16,443 in each group, including about 25% overall with CVD and 5% with HF history.
- HHF outcome defined as HF discharge diagnosis in primary position (HHF-specific) or in any position (HHF-broad).
- Funding: Boehringer-Ingelheim.
- Incidence rates/1000 person-years in empagliflozin vs sitagliptin propensity score-matched initiators:
- 2.1 vs 6.7 for HHF-specific, and
- 10.5 vs 22.2 for HHF-broad outcomes.
- Compared with sitagliptin, over mean 5.3 months, empagliflozin initiation decreased:
- HHF-specific risk by 50% (HR, 0.50; 95% CI, 0.28-0.91), and
- HHF-broad risk by 49% (0.51; 0.39-0.68).
- Consistent results seen with addition of 100 more covariates (0.54; 0.29-0.98 for HHF-specific and 0.54; 0.41-0.71 for HHF-broad), stratification for follow-up duration, and in subgroup analyses by baseline CVD, HF history, sex, and empagliflozin dose.
- Residual confounding cannot be ruled out.
- Possible outcome misclassification.
- Short follow-up duration.
- Small event number.