Key result
SGLT2 inhibitors added to metformin monotherapy were associated with a 22% lower risk of hospitalization for heart failure compared to DPP-4 inhibitors (HR 0.78).
Why the study?
Real-world cardiovascular safety needed investigation in patients with type 2 diabetes mellitus newly starting SGLT2 inhibitors compared with other glucose-lowering drugs as add-on to metformin monotherapy.
Does the addition of SGLT2 inhibitors to metformin monotherapy reduce the risk of cardiovascular events compared to DPP-4 inhibitors or sulfonylureas in patients with type 2 diabetes mellitus?
Population
Patients with type 2 diabetes mellitus on metformin monotherapy in Korea (21,688 pairs in cohort 1; 20,120 pairs in cohort 2)
Comparison
SGLT2 inhibitors vs DPP-4 inhibitors (cohort 1) and vs sulfonylureas (cohort 2)
Design
Retrospective propensity score-matched observational study
Authors
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May support CV safety of SGLT2 inhibitors in Korean metformin users; hypothesis-generating and requires randomized confirmation before practice change.
Cohort (n=83,616)
Does the addition of SGLT2 inhibitors to metformin monotherapy reduce the risk of cardiovascular events compared to DPP-4 inhibitors or sulfonylureas in patients with type 2 diabetes mellitus?
Hazard Ratio: 0.78 (95% CI 0.63–0.97)
Absolute Event Rate: 0.69% vs 0.89%
p-value: p=0.024
In a real-world Korean cohort, adding SGLT2 inhibitors to metformin monotherapy in patients with type 2 diabetes was associated with significantly lower risks of heart failure hospitalization compared to adding DPP-4 inhibitors or sulfonylureas.
Jeon et al. (2020) conducted a cohort in Type 2 Diabetes Mellitus (n=83,616). SGLT2 inhibitors vs. DPP-4 inhibitors was evaluated on Hospitalization for heart failure (HHF) (HR 0.78, 95% CI 0.63-0.97, p=0.024). SGLT2 inhibitors added to metformin monotherapy were associated with a 22% lower risk of hospitalization for heart failure compared to DPP-4 inhibitors (HR 0.78).