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Observational Study
. 2024 Aug 14;10(5):432-443.
doi: 10.1093/ehjcvp/pvae045.

Comparative cardiovascular and renal effectiveness of empagliflozin and dapagliflozin: Scandinavian cohort study

Arvid Engström  1 , Jonas Söderling  1 , Anders Hviid  2   3 , Björn Eliasson  4 , Soffia Gudbjörnsdottir  4   5 , Viktor Wintzell  1 , Kristian Hveem  6   7 , Christian Jonasson  6   7 , Mads Melbye  8   9   6   10 , Björn Pasternak  1   2 , Peter Ueda  1
Affiliations
Observational Study

Comparative cardiovascular and renal effectiveness of empagliflozin and dapagliflozin: Scandinavian cohort study

Arvid Engström et al. Eur Heart J Cardiovasc Pharmacother. .

Abstract

Aims: To assess the comparative cardiovascular and renal effectiveness and safety of empagliflozin vs. dapagliflozin among patients with type 2 diabetes in routine clinical practice.

Methods and results: Cohort study using data from nationwide registers in Sweden, Denmark, and Norway, from June 2014 to June 2021 included 141 065 new users of empagliflozin and 58 306 new users of dapagliflozin. Coprimary outcomes were major cardiovascular events (myocardial infarction, stroke, and cardiovascular death), heart failure (hospitalization or death because of heart failure) and serious renal events (renal replacement therapy, hospitalization for renal events, and death from renal causes). Secondary outcomes were the individual components of the primary outcomes, any cause death, and diabetic ketoacidosis. Use of empagliflozin vs. dapagliflozin was associated with similar risk of major cardiovascular events [adjusted incidence rate: 15.9 vs. 15.8 events per 1000 person-years; HR 1.02, (95% confidence interval 0.97-1.08)], heart failure [6.5 vs. 6.3 events per 1000 person-years; HR 1.05 (0.97-1.14)] and serious renal events [3.7 vs. 4.1 events per 1000 person-years; HR 0.97 (0.87-1.07)]. In secondary outcome analyses, the HRs for use of empagliflozin vs. dapagliflozin were 1.00 (0.93-1.07) for myocardial infarction, 1.03 (0.95-1.12) for stroke, 1.01 (0.92-1.13) for cardiovascular death, 1.06 (1.00-1.11) for any cause death, 0.77 (0.60-0.99) for renal replacement therapy, 1.20 (0.75-1.93) for renal death, 1.01 (0.90-1.12) for hospitalization for renal events and 1.12 (0.94-1.33) for diabetic ketoacidosis.

Conclusion: Use of empagliflozin and dapagliflozin was associated with similar risk of cardiovascular and renal outcomes, mortality, and diabetic ketoacidosis.

Keywords: Chronic kidney disease; Comparative effectiveness; Dapagliflozin; Diabetic ketoacidosis; Empagliflozin; Heart failure; SGLT2 inhibitors.

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Figures

Figure 1
Figure 1
Flow chart of patient inclusion in the study cohort, Sweden, Denmark, and Norway.
Figure 2
Figure 2
Adjusted cumulative incidence of the coprimary outcomes among users of empagliflozin compared with users of dapagliflozin.
Figure 3
Figure 3
Subgroup analyses of coprimary outcomes and the secondary outcomes cardiovascular death and any cause death among users of empagliflozin compared with users of dapagliflozin.
See this image and copyright information in PMC

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