Portal de investigação
Impact of empagliflozin on insulin needs in patients with heart failure and diabetes: An EMPEROR-Pooled analysis
Data de publicação:
Data Ahead of Print:
Autores da FMUP
Participantes de fora da FMUP
- Talha, KM
- Green, J
- Filippatos, G
- Pocock, S
- Zannad, F
- Brueckmann, M
- Schueler, E
- Ofstad, AP
- Anker, SD
- Butler, J
- Rosenstock, J
- Packer, M
Unidades de investigação
Abstract
Aim: To assess the effect of empagliflozin on patients with comorbid heart failure (HF) and diabetes with or without baseline insulin, and to study the impact of empagliflozin on insulin requirements over time. Materials and Methods: We performed a post-hoc analysis of pooled patient-level data from two cardiovascular outcomes trials of empagliflozin in HF (EMPEROR-Reduced and EMPEROR-Preserved trials). We undertook a subgroup analysis stratified by baseline insulin use, including all patients with diabetes. The studied endpoints included the primary composite endpoint of first hospitalization for HF or cardiovascular death, rate of decline of estimated glomerular filtration rate, composite renal outcome and rates of sustained insulin initiation. Results: Among 4794 patients with diabetes, 1333 (658 in empagliflozin, 675 in placebo) were using insulin at baseline. The treatment effect of empagliflozin on the primary endpoint was consistent irrespective of insulin use [no insulin, hazard ratio 0.74, 95% confidence interval (CI) 0.63-0.86; using insulin, hazard ratio 0.81, 95% CI 0.66-1.00, p(interaction) = .49], as was the effect on the rate of decline of the estimated glomerular filtration rate (p(interaction) = .75). There was no effect of empagliflozin on the composite renal outcome in patients using or not using insulin (p(interaction) = .30). Among patients not using insulin at baseline, those randomized to empagliflozin initiated insulin less frequently throughout the follow-up period compared with those receiving placebo (2.6% vs. 3.8%, odds ratio 0.66, 95% CI 0.50-0.88). Conclusions: Empagliflozin exerts a consistent benefit on cardiovascular outcomes and renal function decline, irrespective of baseline insulin use, and reduces the need for sustained insulin initiation in patients with HF and diabetes.
Dados da publicação
- ISSN/ISSNe:
- 1463-1326, 1462-8902
- Tipo:
- Article
- Páginas:
- 2578-2587
- DOI:
- 10.1111/dom.15572
- Link para outro recurso:
- www.scopus.com
DIABETES OBESITY & METABOLISM Wiley-Blackwell Publishing Ltd
Documentos
- Não há documentos
Filiações
Keywords
- cardiovascular disease; clinical trial; empagliflozin; heart failure; insulin therapy
Proyectos asociados
Dapagliflozin, Spironolactone or Both for HFpEF (SOGALDI-PEF) - NCT05676684
Investigador Principal: João Pedro Melo Marques Pinho Ferreira
Ensaio Clínico Académico (SOGALDI-PEF) . AstraZeneca . 2022
Initiation of ARNi and SGLT2i in Patients With HFrEF: Randomized Open-label Trial (INITIATE-HFrEF) -NCT05989503
Investigador Principal: João Pedro Melo Marques Pinho Ferreira
Ensaio Clínico Académico (INITIATE-HFrEF) . Novartis . 2023
Citar a publicação
Talha KM,Green J,Filippatos G,Pocock S,Zannad F,Brueckmann M,Schueler E,Ofstad AP,Ferreira JP,Anker SD,Butler J,Rosenstock J,Packer M. Impact of empagliflozin on insulin needs in patients with heart failure and diabetes: An EMPEROR-Pooled analysis. Diabetes Obes. Metab. 2024. 26. (7):p. 2578-2587. IF:5,800. (1).
