Empagliflozin and semaglutide combination improves glycemic control and BP but not arterial stiffness

A recent 32-week study investigated the effects of empagliflozin, semaglutide, and their combination on vascular function. This study published in the Diabetes, Obesity and Metabolism revealed unexpected results that could reshape the strategies of diabetes management.

The involved a total of 120 patients with type 2 diabetes and these participants were divided into four groups: placebo, semaglutide, empagliflozin, and a combination of both medications. The co-primary outcomes of this study were changes in arterial stiffness and kidney oxygenation, with a specific focus on carotid-femoral pulse wave velocity as a measure of arterial stiffness.

The carotid-femoral pulse wave velocity remained unchanged across all the groups, including the combination treatment which challenges the previous assumptions about the efficacy of these medications on arterial stiffness.

The study uncovered that the combination treatment group experienced a significant 10 mmHg reduction in 24-hour systolic blood pressure, outperforming both the placebo and monotherapy groups. This reduction is considered clinically important and suggests a potential avenue for managing cardiovascular risk in individuals with type 2 diabetes.

Also, the combination treatment demonstrated an impressive increase in glycemic time in range, rising from 72% at baseline to 91% at week 32 without increasing the risk of hypoglycemia. 

Additional secondary outcomes further supported the benefits of combination treatment. The urinary albumin to creatinine ratio decreased by 36% in the combination group when compared to the placebo group.

The study did not observe reduction in arterial stiffness with empagliflozin, semaglutide or their combination, but noticed the unexpected and substantial reduction in 24-hour systolic blood pressure, improved glycemic control and kidney health outcomes in the combination group. This presents a promising development for diabetes treatment. Further research and exploration of these findings may open paths for more effective and comprehensive approaches to managing cardiovascular risks in individuals with type 2 diabetes.

Source:

Vernstrøm, L., Gullaksen, S., Sørensen, S. S., Funck, K. L., Laugesen, E., & Poulsen, P. L. (2024). Separate and combined effects of empagliflozin and semaglutide on vascular function: A 32‐week randomized trial. Diabetes, Obesity & Metabolism. https://doi.org/10.1111/dom.15464