Diabetes, obesity & metabolism

Lower heart and kidney risk with sodium-glucose cotransporter-2 inhibitors compared to dipeptidyl peptidase-4 inhibitors in type 2 diabetes patients without existing heart or kidney disease

Updated

Abstract

SGLT2 inhibitors were associated with a lower risk of cardiorenal disease and heart failure in 105,130 patients with type 2 diabetes.

  • Patients treated with SGLT2 inhibitors had a hazard ratio of 0.56 for developing cardiorenal disease compared to those on DPP4 inhibitors.
  • The risk of heart failure in patients using SGLT2 inhibitors was reduced, with a hazard ratio of 0.71.
  • Chronic kidney disease risk was significantly lower in the SGLT2 group, with a hazard ratio of 0.44.
  • SGLT2 inhibitors were also associated with decreased all-cause mortality (HR 0.67) and cardiovascular mortality (HR 0.61).
  • No significant differences were found for stroke (HR 0.87) and myocardial infarction (HR 0.94) between the treatment groups.

Simplified

Key numbers

0.44
Decrease in CKD Risk
Hazard ratio for CKD in SGLT2i vs. DPP4i
0.71
Decrease in HF Risk
Hazard ratio for heart failure in SGLT2i vs. DPP4i
0.67
Decrease in All-Cause Mortality Risk
Hazard ratio for all-cause mortality in SGLT2i vs. DPP4i

Full Text

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Funding

Competing interests

KIB has received grants to his institution from AstraZeneca for this study and for lectures and consulting from Novo Nordisk, Sanofi, Lilly, Boehringer Ingelheim and Merck Sharp & Dohme. JB holds a full‐time position at AstraZeneca as an epidemiologist. AB acknowledges research support from NIHR, BMA, UKRI, HDR UK, EU and AstraZeneca. DJK has received research grant support from LG Life Sciences, Handok, Boehringer Ingelheim, and AstraZeneca; and has received speaker fees from Novo Nordisk, Novartis Korea, Boehringer Ingelheim, Lilly Korea, Handok, MSD, Hanmi and AstraZeneca. AN has received honoraria from MSD, Astra Zeneca, Eli Lilly, Boehringer Ingelheim and Novo Nordisk. JWE has received honoraria or research grants from AstraZeneca, NovoNordisk, Bayer, Sanofi and MSD. MT is employed by an independent statistical consultant company, Statisticon AB, Uppsala, Sweden, of which AstraZeneca Nordic‐Baltic is a client. SO is a full‐time employee of AstraZeneca. KHH has received research grant support from LG Life Sciences, Handok, Boehringer Ingelheim and AstraZeneca. NK is an employee of Wissenschaftliches Institut für Gesundheitsökonomie und Gesundheitssystemforschung and conducted work on behalf of Kantar Health. JBM, RZ and TY are full‐time employees of AstraZeneca. IK received grants from Astellas Pharma Inc., Boehringer Ingelheim Japan, Kowa Pharmaceutical Co. Ltd, Daiichi Sankyo Company Limited., Mitsubishi Tanabe Pharma Corporation, Shionogi & Co., Ltd, Sumitomo Dainippon Pharma Co., Ltd, Pfizer Japan Inc., Takeda Pharmaceutical Company Limited., Toa Eiyo Ltd, Honorarium: Astellas Pharma Inc., Boehringer Ingelheim Japan, Kowa Pharmaceutical Co. Ltd, Daiichi Sankyo Company Limited., Mitsubishi Tanabe Pharma Corporation, Shionogi & Co., Ltd, Sumitomo Dainippon Pharma Co., Ltd, Pfizer Japan Inc., Takeda Pharmaceutical Company Limited., Toa Eiyo Ltd. TK received grants from Asahi Mutual Life Insurance Co., Boehringer Ingelheim Japan, Daiichi Sankyo Company Limited, Kowa Pharmaceutical Co. Ltd, Mitsubishi Tanabe Pharma Corporation, MSD K.K., Novo Nordisk Pharma Ltd, Sanofi K.K., Takeda Pharmaceutical Company Limited. Lecture/other fees: AstraZeneca K.K., Astellas Pharma Inc., Boehringer Ingelheim Japan, Daiichi Sankyo Company Limited., Eli Lilly Japan K.K., Kowa Pharmaceutical Co. Ltd, Kyowa Hakko Kirin Co., Ltd, Mitsubishi Tanabe Pharma Corporation, MSD K.K., Ono Pharmaceutical Company, Ltd, Sanofi K.K., Sumitomo Dainippon Pharma Co., Ltd, Sanwa Kagaku Kenkyusho Co. Ltd, Taisho Pharmaceutical Co., Ltd and Takeda Pharmaceutical Company Limited.
PubMed

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