Comparative effectiveness of dapagliflozin vs empagliflozin in type 2 diabetes patients

<h2>Objective</h2><ul><li>To compare the real-world effectiveness of dapagliflozin versus empagliflozin in patients with type 2 diabetes (T2D).</li></ul><h2>Methods</h2><ul><li>A target trial emulation using multi-institutional electronic health records from January 2016 to August 2023 was performed.</li><li>Study including 2649 new users of dapagliflozin and 2046 of empagliflozin.</li><li><strong>Primary composite outcome: </strong>Sustained a30% decline in eGFR, end-stage renal disease, hospitalization for heart failure, or all-cause mortality.</li><li><strong>Safety outcomes: </strong>Acute kidney injury, hypoglycemia, urinary tract infection, and fracture.</li><li>Confounding was addressed using inverse probability of treatment weighting (IPTW), and hazard ratios were estimated with Cox regression.</li></ul><h2>Results</h2><ul><li>After IPTW adjustment, 1662 patients remained in each treatment group.</li><li>No significant differences were observed between dapagliflozin and empagliflozin in primary or safety outcomes (Figure 1).</li><li>However, among patients without stable prior ACEI/ARB use, empagliflozin was associated with a higher risk of all-cause mortality.</li></ul><figure class="image"><img style="aspect-ratio:1702/510;" src="https://cdn.megawecare.com/GHBY/Internal-Images/Primary%20Outcome%20in%20Key%20Prespecified%20Subgroups.webp" alt="Primary Outcome in Key Prespecified Subgroups" width="1702" height="510"></figure><h2 data-section="conclusion">Conclusion</h2><ul><li>This trial emulation study provides real-world evidence that dapagliflozin and empagliflozin offer comparable cardiorenal benefits and safety outcomes in patients with type 2 diabetes, supporting their role as effective therapeuticalternatives.</li><li>The increased aII-cause mortality observed among empagliflozin users without stable prior ACEI/ARB exposure highlightstheneedforcareful patient selection and individualized treatment decisions.</li><li>These real-world insights emphasize the value of multidisciplinary collaboration in optimizing SGLT-2i use and reinforce the need for prospective studies to validate subgroup-specific risks and long-term outcomes.</li></ul>

Diabetes Update 2025   Issue 5

<ul><li><a href="#objectives">Objective</a></li><li><a href="#methods">Methods</a></li><li><a href="#results">Results</a></li><li><a href="#conclusion">Conclusion</a></li></ul>

Comparative effectiveness of dapagliflozin vs empagliflozin in type 2 diabetes patients

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