November 2022

Effect of Dapagliflozin on Cause-Specific Mortality in Patients With Heart Failure Across the Spectrum of Ejection Fraction: A Participant-Level Pooled Analysis of DAPA-HF and DELIVER

JAMA Cardiol. 2022; online ahead of print DOI: 10.1001/jamacardio.2022.3736

In a prospective, patient-level pooled meta-analysis of the DAPA-HF and DELIVER trials, dapagliflozin-associated reductions in CV mortality in patients with HF appeared to be principally due to lower rates of sudden death and HF death, regardless of EF.

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Empagliflozin and Left Ventricular Remodeling in People Without Diabetes: Primary Results of the EMPA-HEART 2 CardioLink-7 Randomized Clinical Trial

Circulation. 2022; online ahead of print DOI: 10.1161/CIRCULATIONAHA.122.062769

Among patients with neither diabetes nor significant HF but with risk factors for adverse cardiac remodelling, empagliflozin did not result in a meaningful reduction in change in left ventricular mass indexed (LVMi) to baseline body surface area (BSA) after 6 months as measured by cardiac magnetic resonance imaging.

SGLT2i have demonstrated reverse cardiac remodelling in patients with diabetes or HF, but their effects earlier in the natural history of HF are less well studied.

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October 2022

Network meta-analysis of mineralocorticoid receptor antagonists for diabetic kidney disease

Front Pharmacol. 2022;13:967317 DOI: 10.3389/fphar.2022.967317

A network meta-analysis has found that newer mineralocorticoid receptor antagonists (MRAs) appear to have greater efficacy in reducing urine albumin creatinine ratio (UACR) vs baseline than traditional MRAs in the treatment of diabetic kidney disease (DKD).

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Renal effects of empagliflozin in patients hospitalized for acute heart failure: from the EMPULSE trial

Eur J Heart Fail. 2022; online ahead of print DOI: 10.1002/ejhf.2681

In a post-hoc analysis of EMPULSE in patients with acute heart failure (AHF), the clinical benefit of empagliflozin was consistent regardless of baseline renal function.

In the primary analysis of EMPULSE trial, initiation of empagliflozin in patients hospitalised for acute HF resulted in clinical benefit (a composite of all-cause death, number of HF events and time to first HF event and quality of life) at 90 days. However, the effects of empagliflozin and other sodium-glucose cotransporter-2 inhibitors (SGLT2i) on renal function during a hospital admission for acute HF remain largely unknown.

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Mechanisms underlying the blood pressure-lowering effects of empagliflozin, losartan and their combination in people with type 2 diabetes: A secondary analysis of a randomized crossover trial

Diabetes Obes Metab. 2022; online ahead of print DOI: 10.1111/dom.14864

This prespecified analysis of the RECOLAR study investigated the effects of the sodium-glucose co-transporter-2 inhibitor (SGLT2i), empagliflozin, the angiotensin receptor blocker (ARB), losartan, and their combination on blood-pressure lowering, while studying the mechanisms potentially involved.

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Canagliflozin and atrial fibrillation in type 2 diabetes mellitus: A secondary analysis from the CANVAS Program and CREDENCE trial and meta-analysis

Diabetes Obes Metab. 2022;24:1927–1938 DOI: 10.1111/dom.14772

A pooled analysis from the CANVAS Program and CREDENCE trial found that canagliflozin did not have a significant effect on the incidence of atrial fibrillation/atrial flutter (AF/AFL) in patients with type 2 diabetes and high risk of cardiovascular disease or chronic kidney disease.

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Efficacy and safety of semaglutide on weight loss in obese or overweight patients without diabetes: A systematic review and meta-analysis of randomized controlled trials

Front Pharmacol. 2022;13:935823 DOI: 10.3389/fphar.2022.935823

This meta-analysis investigated the effects of a range of doses of semaglutide in obese or overweight patients without diabetes. Other meta-analyses have investigated effects in patients with or without diabetes and assessed only the 2.4 mg-once-weekly dose of semaglutide.

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Association of Empagliflozin Treatment With Albuminuria Levels in Patients With Heart Failure: A Secondary Analysis of EMPEROR-Pooled

JAMA Cardiol. 2022; online ahead of print DOI: 10.1001/jamacardio.2022.2924

In a post-hoc analysis of EMPEROR-Pooled, empagliflozin was associated with a reduction in the primary outcome irrespective of albuminuria levels at baseline compared with placebo, and there was reduced progression to macroalbuminuria and reversion of macroalbuminuria.

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September 2022

Dapagliflozin in Patients Recently Hospitalized With Heart Failure and Mildly Reduced or Preserved Ejection Fraction

J Am Coll Cardiol. 2022; online ahead of print DOI: 10.1016/j.jacc.2022.07.021

This prespecified analysis of the DELIVER trial found that dapagliflozin had beneficial effects on cardiovascular (CV) outcomes in patients with heart failure (HF) with mildly reduced or preserved left ventricular ejection fraction (LVEF) who were enrolled during or following hospitalisation.

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