Empagliflozin is associated with lower cardiovascular risk compared with dipeptidyl peptidase-4 inhibitors in adults with and without cardiovascular disease: EMPagliflozin compaRative effectIveness and SafEty (EMPRISE) study results from Europe and Asia
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Methods and results
Adults initiating empagliflozin and DPP-4i in 2014–2018/19 from 11 countries in Europe and Asia were compared using propensity score matching and Cox proportional hazards regression to assess differences in rates of primary outcomes: hospitalisation for heart failure (HHF), myocardial infarction (MI), stroke; and secondary outcomes: cardiovascular mortality (CVM), coronary revascularisation procedure, composite outcome including HHF or CVM, and 3-point major adverse cardiovascular events (MACE: MI, stroke and CVM). Country-specific results were meta-analysed and pooled hazard ratios (HR) with 95% confidence intervals (CI) from random-effects models are presented.
In total, 85,244 empagliflozin/DPP4i PS-matched patient pairs were included with overall mean follow-up of 0.7 years. Among those with pre-existing CVD, lower risk was observed for HHF (HR 0.74; 95% CI 0.64–0.86), CVM (HR 0.55; 95% CI 0.38–0.80), HHF or CVM (HR 0.57; 95% CI 0.48–0.67) and stroke (HR 0.79; 95% CI 0.67–0.94) in patients initiating empagliflozin vs DPP-4i. Similar patterns were observed among patients without pre-existing CVD and those with and without pre-existing HF.
Conclusion
These results from diverse patient populations in routine care settings across Europe and Asia demonstrate that initiation of empagliflozin compared to DPP-4i results in favourable cardioprotective effects regardless of pre-existing CVD or HF status.
| Originalsprog | Engelsk |
|---|---|
| Artikelnummer | 233 |
| Tidsskrift | Cardiovascular Diabetology |
| Vol/bind | 22 |
| Udgave nummer | 1 |
| Antal sider | 12 |
| ISSN | 1475-2840 |
| DOI | |
| Status | Udgivet - 2023 |
Bibliografisk note
Funding Information:
This study was funded by the Boehringer Ingelheim & Lilly Diabetes Alliance. We acknowledge and thank Hanna Rinta-Kokko and Pia Vattulainen (IQVIA, Espoo, Finland) for the meta-analyses; Ilkka Tamminen and Nallely Ramirez Solano (IQVIA, Espoo, Finland) for project management and scientific contributions; Niklas Schmedt, Anouk Déruaz-Luyet and Moe H. Kyaw for critical review of the manuscript and editorial support; Dr. Nicola Jaime Adderley (Institute of Applied Health Research, University of Birmingham) for writing the THIN data specific protocol and interpretation of data; and Paula Casajust, Neus Valveny and Alina Gavrus Ion (TFS HealthScience) and Emilie Toresson Grip and Joel Gunnarsson (Quantify) for support conducting EMPRISE studies in Sweden, Finland, and Norway. All authors are guarantors of this report. Kamlesh Khunti and Francesco Zaccardi are supported by the National Institute for Health Research (NIHR) Applied Research Collaboration East Midlands (ARC EM) and the NIHR Leicester Biomedical Research Centre (BRC).
Funding Information:
This study was funded by the Boehringer Ingelheim & Lilly Diabetes Alliance. We acknowledge and thank Hanna Rinta-Kokko and Pia Vattulainen (IQVIA, Espoo, Finland) for the meta-analyses; Ilkka Tamminen and Nallely Ramirez Solano (IQVIA, Espoo, Finland) for project management and scientific contributions; Niklas Schmedt, Anouk Déruaz-Luyet and Moe H. Kyaw for critical review of the manuscript and editorial support; Dr. Nicola Jaime Adderley (Institute of Applied Health Research, University of Birmingham) for writing the THIN data specific protocol and interpretation of data; and Paula Casajust, Neus Valveny and Alina Gavrus Ion (TFS HealthScience) and Emilie Toresson Grip and Joel Gunnarsson (Quantify) for support conducting EMPRISE studies in Sweden, Finland, and Norway. All authors are guarantors of this report. Kamlesh Khunti and Francesco Zaccardi are supported by the National Institute for Health Research (NIHR) Applied Research Collaboration East Midlands (ARC EM) and the NIHR Leicester Biomedical Research Centre (BRC). We acknowledge EMPRISE EU group: Kimberly Brodovicz (BI, US); Kristina Zint (BI, Germany); Johannes Försch (BI, Germany); Doron Rosenzweig, Olga Brodskiy (BI, Israel); Maria Lajer, Mikkel Overgaard (BI, Denmark); Emilie Toresson Grip, Emma Söreskog, Joel Gunnarsson (Quantify Research, Sweden); Kristina Karlsdotter (BI, Sweden); Lotta Stenman, Mikko Tuovinen (BI, Finland); Neus Valveny (Trial Form Support, Spain); Paula Casajust (Trial Form Support, Spain); Ruth Farmer, Andrew Ternouth (BI, UK); Anne Pernille Ofstad (BI, Norway); and East Asia Study Group: Masaomi Nangaku (The University of Tokyo, Japan); Koichi Node (Saga University, Japan); Yusuke Taneda, Atsutaka Yasui (Nippon Boehringer Ingelheim Co., Ltd, Japan); Yutaka Seino (Kansai Electric Power Hospital, Japan); Jingbo Yi (Syneos Health Clinical K.K., Japan); Weiyu Lei (BI, Taiwan); Sunwoo Lee (BI, South Korea); Jinhee Lee (Ajou University School of Medicine, South Korea) for their expertise and assistance throughout all aspects of this study.
Publisher Copyright:
© 2023, BioMed Central Ltd., part of Springer Nature.
ID: 370270404