دورية أكاديمية
Kidney and Cardiovascular Effectiveness of Empagliflozin Compared With Dipeptidyl Peptidase-4 Inhibitors in Patients With Type 2 Diabetes.
| العنوان: | Kidney and Cardiovascular Effectiveness of Empagliflozin Compared With Dipeptidyl Peptidase-4 Inhibitors in Patients With Type 2 Diabetes. |
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| المؤلفون: | Edmonston D; Division of Nephrology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina; Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina. Electronic address: daniel.edmonston@duke.edu., Mulder H; Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina., Lydon E; Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina., Chiswell K; Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina., Lampron Z; Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina., Shay C; Boehringer Ingelheim Pharmaceuticals Inc., Ridgefield, Connecticut., Marsolo K; Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina; Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina., Jones WS; Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina; Division of Cardiology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina., Butler J; Baylor Scott and White Research Institute, Dallas, Texas., Shah RC; Department of Family & Preventive Medicine and the Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois., Chamberlain AM; Department of Quantitative Health Sciences; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota., Ford DE; Johns Hopkins School of Medicine, Baltimore, Maryland., Gordon HS; University of Illinois at Chicago College of Medicine, Chicago, Illinois., Hwang W; Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania., Chang A; Department of Nephrology, Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania., Rao A; Department of Endocrinology, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania., Bosworth HB; Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina; Boehringer Ingelheim Pharmaceuticals Inc., Ridgefield, Connecticut; Division of Cardiology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina; Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Medical Center, Durham, North Carolina; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina; Duke University School of Nursing, Durham, North Carolina., Pagidipati N; Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina; Division of Cardiology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina. |
| المصدر: | The American journal of cardiology [Am J Cardiol] 2024 Jun 15; Vol. 221, pp. 52-63. Date of Electronic Publication: 2024 Apr 17. |
| نوع المنشور: | Journal Article; Comparative Study; Research Support, Non-U.S. Gov't |
| اللغة: | English |
| بيانات الدورية: | Publisher: Excerpta Medica Country of Publication: United States NLM ID: 0207277 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1879-1913 (Electronic) Linking ISSN: 00029149 NLM ISO Abbreviation: Am J Cardiol Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: New York, NY : Excerpta Medica |
| مواضيع طبية MeSH: | Benzhydryl Compounds*/therapeutic use , Glucosides*/therapeutic use , Diabetes Mellitus, Type 2*/drug therapy , Diabetes Mellitus, Type 2*/complications , Dipeptidyl-Peptidase IV Inhibitors*/therapeutic use , Sodium-Glucose Transporter 2 Inhibitors*/therapeutic use , Renal Insufficiency, Chronic*/complications, Humans ; Male ; Female ; Middle Aged ; Glomerular Filtration Rate ; Aged ; Cardiovascular Diseases ; Kidney Failure, Chronic/complications ; Treatment Outcome |
| مستخلص: | Placebo-controlled trials of sodium-glucose co-transporter-2 inhibitors demonstrate kidney and cardiovascular benefits for patients with type 2 diabetes and chronic kidney disease (CKD). We used real-world data to compare the kidney and cardiovascular effectiveness of empagliflozin to dipeptidyl peptidase-4 inhibitors (DPP4is), a commonly prescribed antiglycemic medication, in a diverse population with and without CKD. Using electronic health record data from 20 large US health systems, we leveraged propensity overlap weighting to compare the outcomes for empagliflozin and DPP4i initiators with type 2 diabetes between 2016 and 2020. The primary composite kidney outcome included 40% estimated glomerular filtration rate decrease, incident end-stage kidney disease, or all-cause mortality through 2 years or censoring. We also assessed cardiovascular and safety outcomes. Of 62,197 new users, 20,279 initiated empagliflozin and 41,918 initiated DPP4i. Over a median follow-up of 1.1 years, empagliflozin prescription was associated with a lower risk of the primary outcome (hazard ratio [HR] 0.75, 95% confidence interval [CI] 0.65 to 0.87) than DPP4is. The risks for mortality (HR 0.76, 95% CI 0.62 to 0.92) and a cardiovascular composite of stroke, myocardial infarction, or all-cause mortality (HR 0.81, 95% CI 0.70 to 0.95) were also lower for empagliflozin initiators. No difference in heart failure hospitalization risk between groups was observed. Genital mycotic infections were more common in patients prescribed empagliflozin (HR 1.72, 95% CI 1.58 to 1.88). Empagliflozin was associated with a lower risk of the primary outcome in patients with CKD (HR 0.68, 95% CI 0.53 to 0.88) and those without CKD (HR 0.79, 95% CI 0.67 to 0.94). In conclusion, the initiation of empagliflozin was associated with a significantly lower risk of kidney and cardiovascular outcomes than DPP4is over a median of just over 1 year. The association with a lower risk for clinical outcomes was apparent even for patients without known CKD at baseline. Competing Interests: Declaration of competing interest Boehringer Ingelheim was given the opportunity to review the manuscript for medical and scientific accuracy as well as intellectual property considerations. Dr. Butler reports consultant honoraria from Abbott, American Regent, Amgen, Applied Therapeutic, AstraZeneca, Bayer, Boehringer Ingelheim, Bristol Myers Squibb, Cardiac Dimension, Cardior, CVRx, cytokinetics, Edwards, Element Science, Innolife, Impulse Dynamics, Imbria, Inventiva, Lexicon, Eli Lilly, LivaNova, Janssen, Medtronics, Merck, Occlutech, Novartis, Novo Nordisk, Pfizer, Pharmacosmos, Pharmain, Roche, Sequana, SQ Innovation, and Vifor. Dr. Pagidipati reports research support from Alnylam, Amgen, Boehringer Ingelheim, Eggland's Best, Eli Lilly, Novartis, Novo Nordisk, and Verily Life Sciences; consultation/advisory panels for Bayer, Boehringer Ingelheim, CRISPR Therapeutics, Eli Lilly, Esperion, AstraZeneca, Merck, Novartis, and Novo Nordisk; executive committee member for trials sponsored by Novo Nordisk and Amgen; data safety monitor board for trials sponsored by Johnson and Johnson and Novartis; medical advisory board for Miga Health. The remaining authors have no competing interests to declare. (Copyright © 2024 Elsevier Inc. All rights reserved.) |
| التعليقات: | Comment in: Am J Cardiol. 2024 Jul 15;223:183-185. doi: 10.1016/j.amjcard.2024.05.001. (PMID: 38734398) |
| فهرسة مساهمة: | Keywords: cardiovascular disease; chronic kidney disease; diabetes mellitus; dipeptidyl peptidase-4 inhibitors; empagliflozin; sodium-glucose co-transporter 2 inhibitors |
| المشرفين على المادة: | HDC1R2M35U (empagliflozin) 0 (Benzhydryl Compounds) 0 (Glucosides) 0 (Dipeptidyl-Peptidase IV Inhibitors) 0 (Sodium-Glucose Transporter 2 Inhibitors) |
| تواريخ الأحداث: | Date Created: 20240419 Date Completed: 20240531 Latest Revision: 20240722 |
| رمز التحديث: | 20240722 |
| DOI: | 10.1016/j.amjcard.2024.04.011 |
| PMID: | 38641191 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1879-1913 |
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| DOI: | 10.1016/j.amjcard.2024.04.011 |