Compared with canagliflozin, empagliflozin was associated with a 55% decreased risk of HF-related hospitalization (aHR 0.45; 95% CI 0.34-0.59) in patients with HFpEF.
Cohort (n=3,629)
Does the choice of specific SGLT2 inhibitor (dapagliflozin, empagliflozin, or canagliflozin) reduce HF-related and all-cause hospitalizations in adults with HFpEF?
In a real-world cohort of patients with HFpEF, empagliflozin was associated with a lower risk of HF-related and all-cause hospitalizations compared to both canagliflozin and dapagliflozin.
Hazard Ratio: 0.45 (95% CI 0.34–0.59)
BACKGROUND: Sodium-glucose cotransporter-2 inhibitors (SGLT2i) are recommended by the American Heart Association for management of heart failure with preserved ejection fraction (HFpEF), but little is known about their in-class comparative effectiveness in real-world settings. OBJECTIVES: To assess the in-class comparative effectiveness of SGLT2i for preventing HF-related and all-cause hospitalizations among patients with HFpEF. METHODS: Using MarketScan® Commercial and Medicare Supplemental research databases (2012-2020), this cohort study included adults with HFpEF treated with SGLT2i. Stabilized inverse probability treatment weighted Cox proportional hazards regression was used to compare HF-related and all-cause hospitalizations in three pairwise comparisons: dapagliflozin versus canagliflozin, empagliflozin versus canagliflozin, and dapagliflozin versus empagliflozin. Subgroup and sensitivity analyses were conducted to assess robustness of the main analysis. RESULTS: In total, 3629 SGLT2i users (881 dapagliflozin, 1120 canagliflozin, and 1628 empagliflozin) were included. Compared with canagliflozin, dapagliflozin was associated with decreased risk of HF-related hospitalization (adjusted hazard ratio aHR, 0.75; 95% confidence interval CI, 0.56-1.01) and all-cause hospitalization (aHR, 0.84; 95% CI 0.73-0.97). Compared with canagliflozin, empagliflozin was associated with 55% decreased risk of HF-related hospitalization (aHR, 0.45; 95% CI 0.34-0.59) and 18% decreased risk of all-cause hospitalization (aHR, 0.82; 95% CI 0.73-0.93). Compared with empagliflozin, dapagliflozin was associated with 50% increased risk of HF-related hospitalization (aHR, 1.50; 95% CI 1.09-2.07) and a statistically nonsignificant increase in the risk of all-cause hospitalization (aHR, 1.05; 95% CI 0.92-1.20). CONCLUSIONS: Compared with canagliflozin or dapagliflozin use, empagliflozin use was associated with decreased risk of HF-related and all-cause hospitalizations. Compared with canagliflozin, dapagliflozin was associated with a reduced risk of HF-related and all-cause hospitalizations.
Riaz et al. (Mon,) conducted a cohort in Heart failure with preserved ejection fraction (HFpEF) (n=3,629). Empagliflozin vs. Canagliflozin was evaluated on Heart failure-related hospitalization (aHR 0.45, 95% CI 0.34-0.59). Compared with canagliflozin, empagliflozin was associated with a 55% decreased risk of HF-related hospitalization (aHR 0.45; 95% CI 0.34-0.59) in patients with HFpEF.