Sodium-glucose cotransporter 2 inhibitors pose weak cardiovascular risk in T2D

In Japanese patients with type 2 diabetes (T2D), sodium-glucose cotransporter 2 inhibitors (SGLT2is) pose less of a cardiovascular (CV) risk than other glucose-lowering drugs (oGLDs) and dipeptidyl peptidase-4 inhibitors (DPP4is), a new study has shown.

Researchers compared 33,890 T2D patients treated with SGLT2is to the same number of patients receiving oGLDs. At the same time, they compared 9,876 SGLT2i-treated patients to the same number of DPP4i-treated cases. The primary outcome was the risk of developing CV events.

Patients who initiated SGLT2i vs oGLD medications saw a reduced risk of death (hazard ratio [HR], 0.56, 95 percent confidence interval [CI], 0.47–0.69) and of being hospitalized for heart failure (HR, 0.75, 95 percent CI, 0.64–0.89). Taking these two outcomes as a composite also demonstrated the relative superiority of SGLT2i (HR, 0.65, 95 percent CI, 0.58–0.74).

Similarly, stroke was significantly less likely to develop in those who received SGLT2is vs oGLDs (HR, 0.66, 95 percent CI, 0.52–0.84).

SLGT2is also conferred lower risks of death (HR, 0.52, 95 percent CI, 0.36–0.73) and its composite with hospitalization for heart failure (HR, 0.65, 95 percent CI, 0.51–0.83), as compared with DPP4is.

“Future analyses comparing SGLT2i and oGLD/DPP4i initiators from different patient backgrounds, such as patients with/without metformin, with/without multiple CV risk factors, with lower body mass index, and with established CVD might provide more insight into the potential CV benefits of SGLT2i,” the researchers said.