Cohort study
Sodium–glucose cotransporter 2 inhibitors vs. sitagliptin in heart failure and type 2 diabetes: an observational cohort study
- Retrospective cohort study
- propensity-score fine stratification weighted
- Medicare claims data
Authors' conclusion
In routine US clinical practice, SGLT2i demonstrated robust clinical effectiveness in older adults with HF and type 2 diabetes compared with sitagliptin, with no evidence of heterogeneity across the SGLT2i class or across ejection fraction.
Study context
- Population
- Older adults (≥65 years) with heart failure (HF) and T2DM, US Medicare claims, April 2013 to December 2019
- Participants
- 16,253 vs 43,352
- Exposure
- SGLT2 inhibitors vs sitagliptin
- SGLT2in = 16,253
- Sitagliptinn = 43,352reference
- Outcome
- Composite of:
- All-cause mortality
- HF hospitalisation
- Urgent visit requiring IV diuretics
Main finding
As reported in the abstract
Adjusted hazard ratio
0.72
95% CI 0.67–0.77
SGLT2i vs Sitagliptin
adjusted HR 0.72 (95% CI 0.67–0.77)
Observational data: associations, not effects.
Secondary outcomes
Primary composite outcome by SGLT2i agent, by reduced vs preserved EF, and in subgroups
- Similar associations for all three SGLT2i agents, for reduced and preserved EF, and in subgroups by demographics, comorbidities and other HF treatments
Bias-calibrated HRs for the primary endpoint (negative and positive control outcomes)
- Bias-calibrated HRs ranged between 0.81 and 0.89; observed benefit not fully explained by residual confounding
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Sodium–glucose cotransporter 2 inhibitors vs. sitagliptin in heart failure and type 2 diabetes: an observational cohort study. Eur Heart J. Published 1 June 2023. doi:10.1093/eurheartj/ehad273
Summarised from the published abstract; every number is checked against it