Dapagliflozin and Cardiovascular Outcomes in Type 2 Diabetes
N Engl J Med 2019;380:347–57 DOI 10.1056/NEJMoa1812389
SGLT-2 inhibitors are a type of glucose-lowering therapy which block glucose reabsorption in the proximal tubule and thereby increase glucosuria while showing favourable CV effects. The DECLARE-TIMI 58 trial evaluated CV outcomes with the SGLT-2 inhibitor, dapagliflozin.
Dapagliflozin was noninferior to placebo in terms of major adverse cardiovascular events, and was superior to placebo in terms of CV death or hospitalisation for heart failure. Dapagliflozin also lower rates of progression of renal disease and improvements in CV risk factors versus placebo. Safety concerns with other SGLT-2 inhibitors were not observed with dapagliflozin in this study.