SGLT2 Inhibitors tied to lower CV risk relative to DPP-4 Inhibitors in Diabetes: BMJ

Researchers have found in a new retrospective Study that short-term use of sodium glucose cotransporter 2 (SGLT2) inhibitors is associated with reduced risk for major cardiovascular events in patients with type 2 diabetes, compared with dipeptidyl peptidase-4 (DPP-4) inhibitors.The study has been published in The BMJ.

The researchers conducted the study to compare the risk of cardiovascular events between sodium glucose cotransporter 2 (SGLT2) inhibitors and dipeptidyl peptidase-4 (DPP-4) inhibitors among people with type 2 diabetes in a real world context of clinical practice.

They used Canadian and U.K. databases and matched over 200,000 new users of SGLT2 inhibitors with new users of DPP-4 inhibitors.

They found that compared with DPP-4 inhibitors, SGLT2 inhibitors were associated with a reduced risk of heart attack, stroke or cardiovascular death combined (11.4 events per 1000 person years versus 16.5 events per 1000 person years).

SGLT2 inhibitors were also associated with decreased risks of individual events. For example, heart attack (5.1 v 6.4 events per 1000 person years), cardiovascular death (3.9 v 7.7 events per 1000 person years), heart failure (3.1 v 7.7 events per 1000 person years), and all cause mortality (8.7 v 17.3 events per 1000 person years).

However, SGLT2 inhibitors had more modest benefits for stroke (2.6 v 3.5 events per 1000 person years).

Results were similar in subgroups defined by patient age, sex, past insulin use, and history of cardiovascular disease.

The risk reduction was strongest for cardiovascular death. The SGLT2 inhibitors canagliflozin, dapagliflozin, and empagliflozin all showed similar cardiovascular risk reductions.

The authors concluded that short term use of SGLT2 inhibitors was associated with a decreased risk of cardiovascular events compared with the use of DPP-4 inhibitors.

"These findings suggest that SGLT2 inhibitors offer cardioprotective benefits among people with type 2 diabetes in a real world setting, although additional studies are needed to determine if these benefits persist long term."they said.

The BMJ article (Free)