![]() Only canagliflozin increases the risk of amputations (RR increase 26%) & fractures (RR increase by 11%). SGLT2 inhibitors do not reduce/increase stroke Īll SGLT2 inhibitors reduce the risk of HF hospitalization (RRR ~30%), regardless of prior ASCVD or HF.Īll SGLT2 inhibitors increase the risk of DKA (RR increase by 120%) SGLT2 inhibitors reduce the risk of major adverse CV events (composite of CV death/MI/stroke) in patients with existing ASCVD (RRR 14%), but not in those without ASCVD Only empagliflozin clearly reduces all-cause & CV mortality (in patients with existing ASCVD, RRR 32%) high rate of exclusion during placebo run-in)Ī meta-analysis of the 3 major CV outcome trials of SGLT2 inhibitors (CANVAS, DECLARE & EMPA-REG) shows the following overall patterns: ![]() Multiple risk factors: Male 55+ y/o or female 60+ y/o + tobacco use, HTN, or LDL >3.3 mmol/LĦ4 y/o, male (63%), white (80%), North American (32%)ĪSCVD (41%): CAD (33%), PAD (6%), CVA (8%)ĮGFR 85 (7% with eGFR 17,160 randomized (i.e. Assessment Study (CANVAS) and the Dapagliflozin Effect on Cardiovascular EventsThrombolysis in Myocardial Infarction 58 (DECLARE-TIMI 58) trial. DECLARE is part of the extensive DapaCare clinical program for Farxiga, which will enroll patients in randomized clinical trials, including a wide range of. Overall, dapagliflozin reduced SBP by 2.4 mm Hg (95 CI, 1.92.9 P <0.0001) compared with placebo at 48 months. Overall assessment of the evidence for SGLT2 inhibitors shows several differences between agents in this class empagliflozin appears to have the greatest potential for benefit, whereas canagliflozin has the highest potential for harm.Ĭontext: Summaries of EMPA-REG with empagliflozin & CANVAS with canagliflozinĮstablished atherosclerotic cardiovascular disease (ASCVD IHD, ischemic CVA, PAD) & 40+ y/o Results: The trial comprised 17 160 patients mean age, 64.06.8 years 37.4 women median duration of T2DM, 11 years 40.6 with prevalent cardiovascular disease. Dapaglifozin increases the risk of fungal genital infections (NNH 125) & DKA (NNH 500). NEJM Bottom line: In patients with type 2 diabetes with existing ASCVD or with multiple CV risk factors, dapagliflozin did not reduce the risk of a composite of major adverse cardiovascular events however, it did reduce the risk of HF hospitalizations (NNT 125) at 4.2 years. The sodium-glucose cotransporter 2 inhibitor dapagliflozin reduces the risk for hospitalization for heart failure (HHF) and kidney events in patients with type 2 diabetes mellitus. DECLARE-TIMI 58 (Dapagliflozin Effect on CardiovascuLAR Events) was a multi-national, randomized, double-blind, placebo-controlled Phase IIIB trial jointly. Dapagliflozin and cardiovascular outcomes in type 2 diabetes. The Dapagliflozin Effect on Cardiovascular Events-Thrombolysis In Myocardial Infarction (DECLARE-TIMI 58) trial randomized 17,160 patients to Dapaglifozin. We report albuminuria change in the Dapagliflozin Effect on Cardiovascular Events (DECLARE-TIMI 58) cardiovascular outcome trial, which included populations with lower cardiorenal risk. Abstract Background: Patients with peripheral artery disease (PAD) are at heightened risk of cardiovascular complications.
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