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Cardiometabolic & kidneyCohort study

Comparative Cardiovascular Effectiveness of Empagliflozin Versus Dapagliflozin in Adults With Treated Type 2 Diabetes: A Target Trial Emulation

CirculationPublished

  • Target trial emulation (registry-based cohort study)
  • nationwide, population-based Danish registries
  • inverse probability of treatment and censoring weights
  • 57 potential confounders
Read the original article ↗

Authors' conclusion

Empagliflozin and dapagliflozin initiators had no differences in 6-year cardiovascular outcomes in adults with treated type 2 diabetes with or without coexisting atherosclerotic cardiovascular disease or HF.

Study context

Population
Adults with treated T2DM, Denmark, 2014–2020
Participants
36,670 vs 20,606
Exposure
Empagliflozin vs dapagliflozin initiation, in addition to standard care
  • Empagliflozinn = 36,670
  • Dapagliflozinn = 20,606reference
Outcome
MACE:
  • MI
  • Ischemic stroke
  • HF
  • CV death
Follow-up
6 years

Main finding

As reported in the abstract

MACE
Each group vs dapagliflozinRisk difference (95% CI)
Empagliflozin
0.0%(−0.9% to 1.0%)
Each group vs dapagliflozinRisk ratio (95% CI)
Empagliflozin
1.00(0.91–1.11)

Observational data: associations, not effects.

Further findings

MACE by coexisting ASCVD and heart failure (HF) (subgroups, ITT) · 6 years

With ASCVD: risk difference
−2.3% [95% CI, −8.2% to 3.5%]
With ASCVD: risk ratio
0.92 [95% CI, 0.74 to 1.14]
Without ASCVD: risk difference
0.3% [95% CI, −0.6% to 1.2%]
Without ASCVD: risk ratio
1.04 [95% CI, 0.93 to 1.16]
With HF: risk difference
1.1% [95% CI, −6.5% to 8.6%]
With HF: risk ratio
1.04 [95% CI, 0.79 to 1.37]
Without HF: risk difference
−0.1% [95% CI, −1.0% to 0.8%]
Without HF: risk ratio
0.99 [95% CI, 0.90 to 1.09]
  • findings consistent with the overall result
  • intention-to-treat

MACE, per-protocol analysis (secondary analysis) · 6 years

6-year risk
9.1% versus 8.8%
Risk difference
0.2% [95% CI, −2.1% to 2.5%]
Risk ratio
1.03 [95% CI, 0.80 to 1.32]
  • per-protocol
  • not different

Original publication

Comparative Cardiovascular Effectiveness of Empagliflozin Versus Dapagliflozin in Adults With Treated Type 2 Diabetes: A Target Trial Emulation. Circulation. Published 29 August 2024. doi:10.1161/circulationaha.124.068613
Read the original article ↗PubMedCite RIS · BibTeX

Summarised from the published abstract; every number is checked against it