CVD-REAL 2 extends SGLT2 inhibitor benefits beyond US and European populations
medwireNews: The latest analysis from the CVD-REAL 2 investigators shows reduced cardiovascular (CV) risk associated with sodium-glucose cotransporter (SGLT)2 inhibitor use among diabetes patients from Asia Pacific, North America, and the Middle East.
The research, which appears in the Journal of the American College of Cardiology and was presented today at the American College of Cardiology scientific sessions in Orlando, Florida, USA, includes 408,807 patients identified in national registries in South Korea, Japan, Singapore, Israel, Australia, and Canada. The original CVD-REAL study was based on data from US and European patients.
After matching patients on a score for the propensity to receive an SGLT2 inhibitor (developed for each country individually), the researchers found that patients were less likely to experience CV events during 235,064 episodes of SGLT2 inhibitor use than during 235,064 episodes of using any other antidiabetic agent.
The overall incidence of all-cause death was 0.8 per 100 person–years for SGLT2 inhibitor use, compared with 1.3 per 100 person–years for use of other antidiabetic agents, equating to a significant 49% risk reduction.
Likewise, there was a significant 36% reduction in the risk for hospitalization for heart failure, and risk reductions of 19% for myocardial infarction and 32% for stroke.
There were “no meaningful interactions” that would indicate patients’ demographic, clinical, or treatment characteristics affected the degree of benefit gained from SGLT2 inhibitor treatment. Of note, patients benefitted equally regardless of whether or not they had CV disease at baseline.
Dapagliflozin accounted for around three-quarters of SGLT2 inhibitor use, followed by empagliflozin at 9%, note Mikhail Kosiborod (Saint Luke’s Mid America Heart Institute, Kansas City, Missouri, USA) and co-researchers.
However, there were striking differences between countries; for example, dapagliflozin accounted for around 80% of SGLT2 inhibitor use in South Korea and Australia, but only 25% in Japan, in which ipragliflozin was the other most frequently used SGLT2 inhibitor.
Despite these differences, the benefits of SGLT2 inhibitor use were broadly consistent across countries, suggesting efficacy in patients with varying racial backgrounds and supporting a class effect, says the team.
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