JAMA Netw Open
Heart failure outcomes of SGLT2 inhibitors: Empagliflozin vs. dapagliflozin
HF patients who initiated empagliflozin were less likely to experience the composite of all-cause mortality or hospitalization compared with those who started dapagliflozin. Given that the findings differ from those of prior meta-analyses, authors call for additional confirmatory studies to clarify mechanisms that could explain the outcomes of these SGLT2 inhibitors in HF patients.
For this multicenter, retrospective cohort study, eligible patients had a diagnosis of HF, had never received an SGLT2 inhibitor previously, and were newly started on empagliflozin or dapagliflozin. Patients were followed up for 1 year.
Among 744,914 eligible patients, 28,075 initiated empagliflozin (56.9%) and 12,099 initiated dapagliflozin (43.1%). Following nearest-neighbor matching for demographics, diagnoses, and medication use, there were 11,077 patients in each group. Empagliflozin recipients were less likely to experience the composite of all-cause mortality or hospitalization compared with dapagliflozin recipients (32.2% vs. 34.8%; HR, 0.90; 95% confidence interval [CI0, 0.86-0.94]) in the year following SGLT2 inhibitor initiation. They were also less likely to be hospitalized (HR, 0.90; 95% CI, 0.86-0.94). There was no difference in all-cause mortality between groups (HR, 0.91; 95% CI, 0.82-1.00). Mean hemoglobin A1c and adverse event rates were also similar between groups.
Source:
Modzelewski KL, et al. (2024, May 2). JAMA Netw Open. Comparative Outcomes of Empagliflozin to Dapagliflozin in Patients With Heart Failure. https://pubmed.ncbi.nlm.nih.gov/38696170/