June 16, 2025Annals of Internal Medicine
Comparison of Semaglutide or Dulaglutide Versus Empagliflozin for Risk for Death and Cardiovascular Outcomes Among Patients With Type 2 Diabetes
Key result
Semaglutide and dulaglutide show no significant difference in major cardiovascular events compared with empagliflozin.
- HR 0.89
- 95% CI 0.78 to 1.02
- n=7,899
Why the study?
Does semaglutide or dulaglutide reduce the risk of death and cardiovascular outcomes compared to empagliflozin in patients aged 45 years or older with type 2 diabetes?
Population
Patients aged 45 years or older with type 2 diabetes (n=7899).
Comparison
Initial treatment with semaglutide or dulaglutide. vs Propensity score-matched patients treated with…
Design
Cohort
Follow-up
median of 2.2 years
Authors
Discussion
Loading...
Member takes
Implication
In a target trial emulation of patients with type 2 diabetes, semaglutide showed a potential advantage over empagliflozin for cardiovascular outcomes (driven by a reduction in stroke), whereas dulaglutide did not.
Study Design
Type
Observational (n=7,899)
Multicenter
Yes
Structured PICO
Does semaglutide or dulaglutide reduce the risk of death and cardiovascular outcomes compared to empagliflozin in patients aged 45 years or older with type 2 diabetes?
P
Population
7,899 patients aged 45 years or older with type 2 diabetes treated with semaglutide, dulaglutide, or empagliflozin, followed for a median of 2.2 years.
E
Exposure
Initial treatment with semaglutide or dulaglutide (concomitant treatment with other diabetes medication permitted, excluding other GLP-1 receptor agonists or SGLT2 inhibitors).
C
Comparator
Propensity score-matched patients treated with empagliflozin.
O
Outcome
Composite of death, myocardial infarction (MI), or stroke.composite
Main Result
Hazard Ratio: 0.89 (95% CI 0.78–1.02)
Absolute Event Rate: 20.99% vs 23.56%
In a target trial emulation of patients with type 2 diabetes, semaglutide showed a potential advantage over empagliflozin for cardiovascular outcomes (driven by a reduction in stroke), whereas dulaglutide did not.
Limitations
- Observational study design
- Lack of data on cause-specific mortality
- Residual confounding
Cite This Study
Saeed et al. (2025) conducted an observational in Type 2 diabetes (n=7,899). Semaglutide or dulaglutide vs. Empagliflozin was evaluated on Composite of death, myocardial infarction (MI), or stroke (HR 0.89, 95% CI 0.78 to 1.02). Semaglutide compared with empagliflozin yielded a hazard ratio of 0.89 (95% CI, 0.78-1.02) for death, MI, or stroke, whereas dulaglutide showed similar risks to empagliflozin.