- Sodium-glucose cotransporter-2 inhibitors (SGLT2is) use was associated with a lower risk of heart failure (HF) and chronic kidney disease (CKD) vs dipeptidyl peptidase-4 inhibitors (DPP4is) in type 2 diabetes (T2D) patients free from cardiovascular (CV) and renal disease (CVRD), managed in routine clinical practice.
Why this matters
- Cardiorenal disease risk-lowering effects of SGLT2is reported in clinical trials translate to a multinational real-world setting.
- Findings support increased clinical focus on identifying and implementing early cardiorenal prevention strategies in the treatment of patients with T2D at the risk for cardiorenal events.
- In this multinational observational study, CVRD-free new users of SGLT2is or DPP4is were propensity score-matched in a ratio of 1:1 (n=105,130 in each group) with a total follow-up of 187,955 patient-years.
- Main outcomes: CVRD (diagnosis of HF and CKD), HF, CKD, stroke, myocardial infarction (MI), all-cause and CV mortality.
- Funding: AstraZeneca.
- Dapagliflozin (91.7%) and sitagliptin/linagliptin (55.0%) were the most commonly used agents in the SGLT2is and DPP4is group, respectively.
- SGLT2is vs DPP4is were associated with a lower risk of:
- CVRD (HR, 0.56; 95% CI, 0.42-0.74);
- HF (HR, 0.71; 95% CI, 0.59-0.86);
- CKD (HR, 0.44; 95% CI, 0.28-0.69); and
- all-cause (HR, 0.67; 95% CI, 0.59-0.77) and CV (HR, 0.61; 95% CI, 0.44-0.85) mortality.
- No differences were observed in the risk of stroke (HR, 0.87; 95% CI, 0.69-1.09) and MI (HR, 0.94; 95% CI, 0.80-1.11) between both groups.
- Findings cannot be extended to all patients with T2D.