Empagliflozin Cuts Risk of Hospitalization for Heart Failure for Adults With Type 2 Diabetes

Empagliflozin (Jardiance; Boehringer Ingelheim, Eli Lilly and Company) was associated with a reduction in the risk of hospitalization for heart failure compared with 2 other classes of glucose-lowering therapies in adults with type 2 diabetes in routine care, according to 2 analyses from the EMPRISE real-world study.

“Heart failure is present in up to 30% of all people with type 2 diabetes, therefore it is critical that health care professionals treating this population have treatments that demonstrate cardiovascular effectiveness in routine care,” Elisabetta Patorno, MD, DrPH, from the Division of Pharmacoepidemiology and Pharmacoeconomics at Brigham and Women’s Hospital and an associate professor of Medicine at Harvard Medical School, said in a statement. “These 5-year results from EMPRISE, showing empagliflozin was associated with a decreased risk of hospitalization for heart failure and for death, are encouraging data for adults with type 2 diabetes and their care team.”

Relative risk reductions were 50% with empagliflozin compared with dipeptidyl peptidase-4 (DPP-4) inhibitors and 30% compared with glucagon-like peptide 1 (GLP-1) receptor agonists.

The results were presented at the American Diabetes Association Scientific Sessions 2022 in New Orleans, Louisiana.

Compared with DPP-4 inhibitors, empagliflozin was also associated with a 40% reduction in relative risk of all-cause mortality in individuals who had Medicare. In the overall population in the study, empagliflozin was associated with a 12% reduction in the risk of composite outcomes of myocardial infarction or stroke compared with DPP-4 inhibitors.

Further, compared with GLP-1 receptor agonists, empagliflozin was associated with a similar risk of all-cause mortality, heart attack, and stroke,. All results for empagliflozin compared with GLP-1 receptor agnostic, and liraglutide specifically, were consistent for individuals with and without cardiovascular disease.

“We are delighted that this analysis from EMPRISE has highlighted that Jardiance, compared with other medicines, can reduce the need for hospitalization with heart failure, as well as overall deaths in people with type 2 diabetes. This is welcome data for the 60 million people living with cardio-metabolic conditions globally,” Waheed Jamal, MD, corporate vice president and head of CardioMetabolic Medicine at Boehringer Ingelheim, said in the statement.

The results from the EMPRISE real-world study, which assessed the first 5 years of use with empagliflozin in the United States, complement previously reported data from the landmark EMPA-REG OUTCOME trial, which showed that empagliflozin had a 35% relative risk reduction in hospitalization for heart failure compared with the placebo in adults with type 2 diabetes and established cardiovascular disease. Additionally, the trial showed a 38% relative risk reduction in cardiovascular death with empagliflozin compared with the placebo.

The findings from the EMPRISE confirmed the well-established safety profile of empagliflozin. Compared with DPP-4 inhibitors, empagliflozin was associated with a reduction in relative risk of acute kidney injury. There was an increase in relative risk of hospitalization from diabetic ketoacidosis, which is consistent with empagliflozin’s known safety profile.

Additionally, the risks for bladder and renal cancer, fractures, and lower-limb amputations, were similar.

The EMPRISE study in the United States included nearly 500,00 individuals in real-world care settings, according to investigators.

Reference

Real-world evidence study shows heart failure benefits. Boehringer Ingelheim. News release. June 6, 2022. Accessed June 9, 2022. https://www.boehringer-ingelheim.com/human-health/metabolic-diseases/diabetes/emprise-study