Not all sodium-glucose cotransporter 2 inhibitors are created equal


  • Heather Mason
  • Univadis Medical News
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A meta-analysis of six outcomes trials of four sodium-glucose cotransporter 2 (SGLT2) inhibitors revealed a risk reduction of major adverse cardiovascular (CV) events (MACE) and heterogeneity of CV death, according to an article published in JAMA Cardiology.

The systematic literature search found 145 records, of which six randomised, placebo-controlled CV and kidney outcomes trials of SGLT2 inhibitors in patients with type 2 diabetes, met the inclusion criteria. The outcomes included time to the first event of (1) the composite of MACE (myocardial infarction, stroke, or CV death), (2) the composite of hospitalisation for heart failure (HHF) or CV death (HHF/CV death), and (3) kidney composite outcomes.

Overall, SGLT2 inhibitors were associated with a reduced risk of MACE and kidney outcomes with no significant heterogeneity of associations with outcome. Associated risk reduction for HHF was consistent across the trials, whereas significant heterogeneity of associations with outcome was observed for CV death.

Furthermore, the results suggest that empagliflozin is associated with reduced risk for CV death, canagliflozin with reduced risk for MACE and for the incidence and progression of kidney disease, and dapagliflozin with reduced risk for HHF.