Comparative cardiovascular and renal effectiveness of empagliflozin and dapagliflozin: Scandinavian cohort study
Authors' conclusion
Use of empagliflozin and dapagliflozin was associated with similar risk of cardiovascular and renal outcomes, mortality, and diabetic ketoacidosis.
Study context
- Population
- Patients with T2DM in routine clinical practice, Sweden, Denmark and Norway, June 2014 to June 2021
- Participants
- 141,065 vs 58,306
- Exposure
- Empagliflozin vs dapagliflozin
- Empagliflozinn = 141,065
- Dapagliflozinn = 58,306reference
- Outcome
- Coprimary: major CV events (MI, stroke, CV death); HF (hospitalization or death because of HF); serious renal events (renal replacement therapy, hospitalization for renal events, death from renal causes)
Methodological detailsnationwide registers, Sweden, Denmark and Norway
- Nationwide registers
- Sweden, Denmark and Norway
Main finding
As reported in the abstract
Empagliflozin
- Major CV events
- 15.9 events per 1000 person-years
- HF
- 6.5 events per 1000 person-years
- Serious renal events
- 3.7 events per 1000 person-years
Dapagliflozin
- Major CV events
- 15.8 events per 1000 person-years
- HF
- 6.3 events per 1000 person-years
- Serious renal events
- 4.1 events per 1000 person-years
Major CV events
Empagliflozin15.9 events per 1000 person-years
Dapagliflozin15.8 events per 1000 person-years
HF
Empagliflozin6.5 events per 1000 person-years
Dapagliflozin6.3 events per 1000 person-years
Serious renal events
Empagliflozin3.7 events per 1000 person-years
Dapagliflozin4.1 events per 1000 person-years
Empagliflozin vs DapagliflozinHazard ratio (95% CI)
Major CV events
1.02(0.97–1.08)
HF
1.05(0.97–1.14)
Serious renal events
0.97(0.87–1.07)
Observational data: associations, not effects.
Secondary outcomes
| Outcome | HR (95% CI) | |
|---|---|---|
| Components of primary outcomes and any cause deathEmpagliflozinvs DapagliflozinMI | 1.00 (0.93–1.07) | |
| Components of primary outcomes and any cause deathEmpagliflozinvs DapagliflozinStroke | 1.03 (0.95–1.12) | |
| Components of primary outcomes and any cause deathEmpagliflozinvs DapagliflozinCV death | 1.01 (0.92–1.13) | |
| Components of primary outcomes and any cause deathEmpagliflozinvs DapagliflozinAny cause death | 1.06 (1.00–1.11) | |
| Components of primary outcomes and any cause deathEmpagliflozinvs DapagliflozinRenal replacement therapy | 0.77 (0.60–0.99) | |
| Components of primary outcomes and any cause deathEmpagliflozinvs DapagliflozinRenal death | 1.20 (0.75–1.93) | |
| Components of primary outcomes and any cause deathEmpagliflozinvs DapagliflozinHospitalization for renal events | 1.01 (0.90–1.12) | |
| 0.512Hazard ratio (log scale) |
Safety
| Outcome | HR (95% CI) | |
|---|---|---|
| Diabetic ketoacidosis | 1.12 (0.94–1.33) | |
| 0.512Hazard ratio (log scale) |
Original publication
Comparative cardiovascular and renal effectiveness of empagliflozin and dapagliflozin: Scandinavian cohort study. Eur Heart J Cardiovasc Pharmacother. Published 25 June 2024. doi:10.
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