Hormonal
SGLT2 inhibitors (specifically empagliflozin) reduce major adverse cardiovascular events (MACE) and cardiovascular death in patients with Type 2 Diabetes and established cardiovascular disease.
If you have Type 2 Diabetes and established cardiovascular disease, empagliflozin (10 or 25 mg daily) can significantly reduce your risk of major cardiovascular events and cardiovascular death. This benefit is observed even in patients with moderately reduced kidney function (eGFR > 30). The mechanism is likely related to hemodynamic changes rather than just glucose lowering.
empagliflozin significantly (albeit by a small margin) improved the occurrence of the primary major adverse cardiovascular event outcome of the trial (cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke) by 14% compared with placebo (hazard ratio [HR], 0.86; 95% confidence interval [95% CI], 0.74 to 0.99; P50.04), which was mainly driven by a significant 38% reduction in cardiovascular death (HR, 0.62; 95% CI, 0.49 to 077; P,0.001) (6).
Why this rating
Based on the large, randomized, placebo-controlled EMPA-REG OUTCOME trial.
Source
SGLT2 Inhibition in the Diabetic Kidney—From Mechanisms to Clinical Outcome
Erik J.M. van Bommel et al. · Clinical Journal of the American Society of Nephrology · 2017
DOI 10.2215/cjn.06080616
More from this paper
Related findings · Hormonal
- Initial treatment for type 2 diabetes should be a combination of metformin and either an SGLT-2 inhibitor or a GLP-1 receptor agonist to achieve cardiorenal protection, rather than monotherapy or older agents like sulfonylureas.Strong
- For patients with specific monogenic obesity syndromes (leptin deficiency, POMC/PCSK1/LEPR mutations), targeted pharmacotherapy (recombinant leptin or setmelanotide) is highly effective and should be prioritized, unlike in polygenic obesity.Strong
- Continued weekly administration of 2.4 mg subcutaneous semaglutide prevents weight regain and promotes further weight loss in adults with overweight or obesity, whereas switching to placebo results in significant weight regain.Strong
This is one finding among thousands. Every one is graded and traced to its source, so you can see what the evidence actually supports. Browse the research →