Publications
Stay up to date with our literature reviews which are curated by experts to feature the most important publications released each month. Explore our publications for access to concise summary slides for your own use.
Empagliflozin for Heart Failure With Preserved Left Ventricular Ejection Fraction With and Without Diabetes
Circulation 2022; online ahead of print
In patients enrolled in EMPEROR-Preserved, empagliflozin significantly reduced the risk of heart failure (HF) outcomes irrespective of diabetes status.
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Design of the COmbinatioN effect of FInerenone anD EmpaglifloziN in participants with chronic kidney disease and type 2 diabetes using an UACR Endpoint study (CONFIDENCE)
Nephrol Dial Transplant 2022 Jun 14;gfac198. Online ahead of print. doi: 10.1093/ndt/gfac198.
CONFIDENCE is a new trial currently recruiting. The aim is to demonstrate that 6 months’ dual therapy with finerenone and empagliflozin is superior for reducing albuminuria versus either agent alone.
Despite available interventions, people with T2D remain at risk of chronic kidney disease, which puts them at further risk of kidney failure, CV morbidity, and all-cause mortality. There is therefore a need to slow or attenuate the progression of chronic kidney disease (CKD) and reduce CV morbidity and mortality in this population.
Finerenone and sodium-glucose cotransporter-2 inhibitors (SGLT2i) can both reduce kidney and CV risks, acting via both shared and distinct pathophysiological pathways. Results from post hoc subgroup analyses and a preclinical model suggest dual therapy may provide additive renoprotective effects than using either class alone.
Cardiovascular Outcomes in Patients Initiating First-Line Treatment of Type 2 Diabetes With Sodium–Glucose Cotransporter-2 Inhibitors Versus Metformin: A Cohort Study
Ann Intern Med 2022; doi:10.7326/M21-4012
This cohort study found that those initiating a SGLT2i as their first-line treatment for T2D showed a similar risk for a composite outcome of MI, stroke, and mortality – and lower risk for a composite of hospitalisation for heart failure (HHF) and mortality. Compared with those receiving metformin as their first-line treatment, the SGLT2i safety profile was similar, except for an increased risk of genital infections.
Randomized Controlled Trial of the Hemodynamic Effects of Empagliflozin in Patients With Type 2 Diabetes at High Cardiovascular Risk: The SIMPLE Trial
Diabetes 2022;71:812–20 doi.org/10.2337/db21-0721
In this analysis of data from the SIMPLE trial, empagliflozin did not reduce left heart filling pressure more than placebo at submaximal exercise in patients with T2D at high CV risk. However, it was observed that empagliflozin reduced pulmonary capillary wedge pressure (PCWP) at a magnitude of clinical significance in patients at rest. The findings suggest cardiac benefits beyond the diuretic effect of sodium-glucose co-transporter-2 inhibitor (SGLT2i) treatment and could explain a significant part of the CV benefits observed in clinical trials.
Initial Decline (“Dip”) in Estimated Glomerular Filtration Rate Following Initiation of Dapagliflozin in Patients With Heart Failure and Reduced Ejection Fraction: Insights From DAPA-HF
Circulation 2022; Online ahead of print doi: 10.1161/CIRCULATIONAHA.121.058910
The results of this subgroup analysis from DAPA-HF show that – although estimated glomerular filtration rate (eGFR) decline is generally associated with poorer prognosis in most situations – an initial dip with a sodium-glucose co-transporter-2 inhibitor (SGLT2i) may be associated with slower rate of decline in kidney function.
The SGLT2 Inhibitor Empagliflozin in Patients Hospitalized For Acute Heart Failure: A Multinational Randomized Trial
Nature Med 2022;28:568–74 doi: 10.1038/s41591-021-01659-1
Empagliflozin is well tolerated in patients hospitalised for acute heart failure, resulting in significant clinical benefit 90 days after treatment initiation.
Semaglutide Once a Week in Adults With Overweight or Obesity, With or Without Type 2 Diabetes in an East Asian Population (STEP 6): A Randomised, Double-Blind, Double-Dummy, Placebo Controlled, Phase 3a Trial
Lancet Diabetes Endocrinol 2022;10:193–206. doi.org/10.1016/S2213-8587(22)00008-0
In this Phase 3a trial in an east Asian population, semaglutide 2.4 mg QW was shown to have superior and clinical meaningful reductions in bodyweight versus placebo, as well as greater reductions in abdominal visceral fat.
Effect of Weekly Subcutaneous Semaglutide vs Daily Liraglutide on Body Weight in Adults With Overweight or Obesity Without Diabetes: The STEP 8 Randomized Clinical Trial
JAMA 2022;327(2):138–50 doi:10.1001/jama.2021.23619
Among adults with overweight or obesity without diabetes, QW SC semaglutide compared with QD SC liraglutide – added to counselling for diet and physical activity – resulted in significantly greater weight loss at 68 weeks.
Efficacy and Safety of Canagliflozin Versus Glimepiride in Patients With Type 2 Diabetes Inadequately Controlled With Metformin (CANTATA-SU): 52 Week Results From a Randomised, Double-blind, Phase 3 Non-inferiority Trial
Lancet 2013;382:941–50 doi.org/10.1016/S0140-6736(13)60683-2
In the CANTATA-52 trial, canagliflozin was non-inferior to glimepiride for the primary endpoint of glucose-lowering at 52 weeks – and the highest dose achieved superiority.
Dapagliflozin and Cardiovascular Outcomes in Type 2 Diabetes
N Engl J Med 2019;380:347–57 DOI 10.1056/NEJMoa1812389
Dapagliflozin was found to be noninferior to placebo in terms of major adverse cardiovascular events in the DECLARE-TIMI 58 trial.