Recent studies and analyses of the results of empagliflozin treatment


Authors: Emil Martinka
Authors‘ workplace: Národný endokrinologický a diabetologický ústav, n. o., Ľubochňa
Published in: Forum Diab 2020; 142(3): 198-202
Category:

Overview

5 years after the RCT of the EMPA-REG OUTCOME study, Empagliflozin has established itself not only as an effective and safe drug that lowers glycemia independent of insulin secretion and insulin sensitivity of tissues in all patients with type 2 diabetes mellitus, but also as the strongly recommended choice in patients with cardiovascular (CVD) and/or renal disease, and the preferred treatment in patients at high risk of heart disease, with the aim of reducing heart failure, hospitalization for heart failure (hHF), as well as the onset of and progression of the existing chronic kidney disease (CKD). The RWE (real world evidence) study EMPRISE has confirmed the CV benefit of the reduction of mortality and hospitalization for HF, and also in routine clinical practice. Subsequent sub-analyses of the EMPA-REG OUTCOME study, which were recently presented at the major ADA and EASD world congresses, also pointed to other favorable medical as well as economic parameters. These findings further substantiate and support the importance of iSGLT-2 treatment and its preference in therapeutic approaches.

Keywords:

empagliflozin – EMPA-REG OUTCOME – EMPRISE


Sources
  1. Buse JB, Wexler DJ, Tsapas A et al. 2019 update to: Management of hyperglycaemia in type 2 diabetes 2018. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetologia 2020; 63(2): 221–228. Dostupné z DOI: <https://doi.org/10.1007/s00125–019–05039-w>. Diabetes Care 2020 ; 43(2): 487–493. Dostupné z DOI: <https://doi.org/10.2337/dci19–0066>.
  2. Butler J, Packer M, Anker SD et al. Empagliflozin for the treatment of chronic heart failure and a reduced ejection fraction in patients with and without diabetes: new results of the EMPEROR-Reduced trial. EASD 2020. Dostupné z DOI: <https://www.easd.org/virtualmeeting/home.html>.
  3. Gaede P, Oellgaard J, Carstensen B et al. Years of life gained by multifactorial intervention in patients with type 2 diabetes mellitus and microalbuminuria: 21 years follow-up on the Steno-2 randomised trial. Diabetologia 2016; 59(11): 2298–2307. Dostupné z DOI: <http://dx.doi.org/10.1007/s00125–016–4065–6>.
  4. Gilbert RE, Krum H. Heart failure in diabetes: effects of anti-hyperglycaemic drug therapy. Lancet 2015; 385(9982): 2107–2117. Dostupné z DOI: <http://dx.doi.org/10.1016/S0140–6736(14)61402–1>.
  5. Heerspink HJ, Stefánsson BV, Correa-Rotter R et al. Dapagliflozin in Patients with Chronic Kidney Disease. N Engl J Med 2020; 383(15):1436–1446. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa2024816>.
  6. Inzucchi SE, Kraus BJ, Weir MR et al. 132-LB: Implications of Initial eGFR Response to Empagliflozin Treatment Effects. American Diabetes Association (ADA) 80th Scientific Sessions 2020, June 12–16; Chicago, IL, USA. Virtual Meeting. Dostupné z DOI: <https://doi.org/10.2337/db20–132-LB>.
  7. Inzucchi SE, Zinman B, Wanner C et al. 131-LB: Empagliflozin Reduces the Total Burden of All-cause Hospitalizations. American Diabetes Association (ADA) 80th Scientific Sessions 2020, June 12–16. Virtual Meeting. Dostupné z DOI: <https://doi.org/10.2337/db20–131-LB>.
  8. Kraus BJ, Weir MR, Bakris GL et al. Implications of initial EGFR response to empagliflozin treatment effects. ePoster 559. American Diabetes Association (ADA) 80th Scientific Sessions 2020, June 12–16. Virtual Meeting. Dostupné z WWW: <www.easd.org/virtualmeeting/home.html#!resources/implications-of-initial-egfr-response-to-empagliflozin-treatment-effects-7ca411cf-d906–4e07-a99b-a0d636d4404d>.
  9. McGuire DK, Zinman B, Inzucchi SE et al. Effects of empagliflozin on first and recurrent clinical events in patients with type 2 diabetes and atherosclerotic cardiovascular disease: a secondary analysis of the EMPA-REG OUTCOME trial. Lancet Diabetes Endocrinol 2020; 8(12): 949–959. Dostupné z DOI: <http://dx.doi.org/10.1016/S2213–8587(20)30344–2>.
  10. McMurray JJ, Solomon SD, Inzucchi SE et al. Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction. N Engl J Med 2019; 381(21): 1995–2008. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1911303>.
  11. Monami M, Genovese S, Mannucci E. Cardiovascular Safety Of Sulfonylureas: A Meta-Analysis Of Randomised Clinical Trials. Diabetes Obes Metab 2013; 15(10):938–953. Dostupné z DOI: <http://dx.doi.org/10.1111/dom.12116>.
  12. Najafzadeh M, Pawar A, Déruaz-Luyet A et al. PDB128 Reduced health­care utilization in patients using empaglifozin: an interim analysis from the empaglifozin comparative efectiveness and safety (EMPRISE) study. Value Health 2019; 22: S161.
  13. Nissen SE, Wolski K. Effect of Rosiglitazone on the Risk of Myocardial Infarction and Death from Cardiovascular Causes. N Engl J Med 2007; 356(24):2457–2471. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa072761>.
  14. Neeland IJ, Eliasson B, Kasai T et al. 1128-P: Empagliflozin and Obstructive Sleep Apnea:Exploratory Analysis from the EMPA-REG OUTCOME® Trial. American Diabetes Association (ADA) 80th Scientific Sessions 2020, June 12–16. Virtual Meeting. Dostupné z DOI: <https://doi.org/10.2337/db20–1128-P >.
  15. Packer M, Anker SD, Butler J et al. Cardiovascular and Renal Outcomes with Empagliflozin in Heart Failure. N Engl J Med 2020; 383(15): 1413–1424. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa2022190>.
  16. Patorno E, Pawar A, Lily G et al. 133-LB: Cardiovascular outcomes in older adults initiating Empagliflozin vs DPP4 inhibitors and GLP1 receptor agonists: a subgroup analysis from the EMPRISE study. Poster. American Diabetes Association (ADA) 80th Scientific Sessions 2020, June 12–16. Virtual Meeting. Dostupné z WWW: < https://doi.org/10.2337/db20–133-LB>.
  17. Patorno E, Pawar A, Lily G et al. 134-LB: Effectiveness and safety of empagliflozin in routine care patients: interim results from the EMPagliflozin compaRative effectIveness and SafEty (EMPRISE) study. Poster. American Diabetes Association (ADA) 80th Scientific Sessions 2020, June 12–16. Virtual Meeting. Dostupné z DOI: <https://doi.org/10.2337/db20–134-LB>.
  18. Patorno E, Pawar A, Franklin JM et al. Empagliflozin and the Risk of Heart Failure Hospitalization in Routine Clinical Care A First Analysis From the EMPRISE Study. Circulation 2019; 139(25): 2822–2830. Dostupné z DOI: <http://dx.doi.org/10.1161/CIRCULATIONAHA.118.039177>.
  19. [Action to Control Cardiovascular Risk in Diabetes Study Group]. Effects of Intensive Glucose Lowering in Type 2 Diabetes. N Engl J Med 2008; 358(24): 2545–2559. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa0802743>.
  20. Schernthaner G, Shehadeh, N, Ametov AS et al. Worldwide inertia to the use of cardiorenal protective glucose-lowering drugs (SGLT2i and GLP-1 RA) in high-risk patients with type 2 diabetes. Cardiovasc Diabetol 2020; 19(1):185. Dostupné z DOI: <http://dx.doi.org/https://doi.org/10.1186/s12933–020–01154-w>.
  21. Vaduganatham M et al. 30_OR. Empagliflozin delays need for insulin initiation in patients with and lowers insulin requirements in patients with type 2 diabetes and cardiovascular disease. Finding from EMPA-REG OUTCOME. American Diabetes Association (ADA) 80th Scientific Sessions 2020, June 12–16. Virtual Meeting. Dostupné z DOI: <https://doi.org/10.2337/db20–30-OR>.
  22. Verma S, Leiter LA, Sharma A et al. 28-OR: How early after treatment initiation are the CV benefits of empagliflozin apparent? A post hoc analysis of EMOPA-REG OUTCOME. American Diabetes Association (ADA) 80th Scientific Sessions 2020, June 12–16. Virtual Meeting. Dostupné z DOI: <https://doi.org/10.2337/db20–28-OR>.
  23. Verma S, Goldenberg RM, Bhatt DL et al. Dipeptidyl peptidase-4 inhibitors and the risk of heart failure: a systematic review and meta-analysis. CMAJ Open 2017; 5(1): E152-E177. Dostupné z DOI: <http://dx.doi.org/10.9778/cmajo.20160058>.
  24. Wanner C, Inzucchi SE, Lachin JM et al. Empagliflozin and Progression of Kidney Disease in Type 2 Diabetes. N Engl J Med 2016, 374: 323–334. Dostupné z DOI: <http://doi: 10.1056/NEJMoa1515920>.
  25. Zinman B, Wanner C, Lachin JM et al. Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes. N Engl J Med 2015; 373(22): 2117–2128. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1504720>.
Labels
Diabetology Endocrinology Internal medicine
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