May 2023

The Improved Health Utility of Once-Weekly Subcutaneous Semaglutide 2.4 mg Compared With Placebo in the STEP 1-4 Obesity Trials

Diabetes Obes Metab 2023 DOI 10.1111/dom.15090

Patient-reported outcomes and evaluations serve to shape policy through cost-effectiveness comparisons, assessing the incremental expenses of an intervention against the incremental enhancement in quality-adjusted life years.

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June 2023

Effect of Canagliflozin on Heart Failure Hospitalization in Diabetes According to Baseline Heart Failure Risk

JACC Heart Fail. 2023. DOI: 10.1016/j.jchf.2023.03.025

In the CANVAS programme, canagliflozin reduced the risk of HF hospitalisation among individuals with T2D. This post hoc analysis evaluated heterogeneity in the treatment effects of canagliflozin on HF hospitalisation according to baseline HF risk as assessed by two diabetes-specific HF risk scores: WATCH-DM (for participants without prevalent HF) and TRS-HFDM (all participants).

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Racial Differences in Quality of Life in Patients With Heart Failure Treated With Sodium-Glucose Cotransporter 2 Inhibitors: A Patient-Level Meta-Analysis of the CHIEF-HF, DEFINE-HF, and PRESERVED-HF Trials

Circulation. 2023; DOI: 10.1161/CIRCULATIONAHA.122.063263

Health status outcomes, including symptoms, function and QoL are worse for Black compared with White patients with HF. However, it is not known whether the health status benefits of SGLT2i are similar across races. This patient-level meta-analysis used data from three US-based trials that enrolled a substantial proportion of Black patients (DEFINE-HF, PRESERVED-HF and CHIEF-HF) to assess the effects of SGLT2is versus placebo on health status for Black compared with White patients with HF.

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April 2023

Advances in the Management of Heart Failure with Reduced Ejection Fraction; The Role of SGLT2is, ARNI, Myotropes, Vericiguat, and Anti-inflammatory Agents: A Mini-review

Curr Pharm Des. 2023; online ahead of print DOI: 10.2174/1381612829666230316142450

This mini-review summarises recent data on new treatments for HFrEF. The article highlights that SGLT2i have revolutionised the management of HFrEF via significant reductions in CV mortality and HF hospitalisations. The role of sacubitril/valsartan as a potential replacement for ACEis and ARBS is discussed. New data on promising disease-modifying therapies are highlighted including vericiguat, which restores the impaired cyclic guanosine monophosphate pathway, and omecamtiv mecarbil, which stimulates cardiac myosin without marked arrhythmogenesis. The lack of success in developing anti-inflammatory agents for HFrEF, despite inflammasome activity being implicated in HFrEF pathophysiology, is discussed.

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Effects of Dapagliflozin on Hospitalisations in People with Type 2 Diabetes: Post-hoc Analyses of the DECLARE-TIMI 58 Trial

Lancet Diabetes Endocrinol. 2023;11:233–241 DOI: 10.1016/S2213-8587(23)00009-8

In patients with T2D at high risk of CV or kidney disease, SGLT2is consistently reduce the risk of HF hospitalisations. Less is known about their effects on hospitalisation from any cause, especially in patients with T2D without ASCVD, which includes most of the global population with T2D. Post hoc analyses of DECLARE-TIMI 58 assessed the effect of dapagliflozin on the risks of hospitalisations for any cause and for specific causes in patients with T2D with and without ASCVD.

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Outcomes with Finerenone in Participants with Stage 4 CKD and Type 2 Diabetes: A FIDELITY Subgroup Analysis

Clin J Am Soc Nephrol. 2023; online ahead of print DOI: 10.2215/CJN.0000000000000149

Patients with stage 4 CKD and T2D have limited treatment options to reduce their persistent CV and kidney risk. This post hoc analysis of the FIDELITY database evaluated the effect of finerenone vs placebo in 890 patients with stage 4 CKD and T2D.

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May 2023

Cardiac and Kidney Benefits of Empagliflozin in Heart Failure Across the Spectrum of Kidney Function: Insights From the EMPEROR-Preserved Trial

European Journal of Heart Failure 2023 DOI 10.1002/ejhf.2857

In the EMPEROR-Preserved trial, empagliflozin was found to improve the clinical outcomes of patients with heart failure and preserved ejection fraction (HFpEF). This pre-specified analysis sought to explore the effect of empagliflozin on cardiovascular (CV) and kidney outcomes across different levels of kidney function.

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Benefits and Harms of Drug Treatment for Type 2 Diabetes: Systematic Review and Network Meta-Analysis of Randomised Controlled Trials

BMJ 2023;381:e074068 DOI 10.1136/bmj-2022-074068

Keeping abreast of the rising volume of randomized trials in adults with type 2 diabetes presents a formidable task. Recent randomized trials have shown cardiovascular and kidney advantages with finerenone, an innovative non-steroidal mineralocorticoid receptor antagonist, and weight loss with tirzepatide, a dual glucose-dependent insulinotropic polypeptide/glucagon-like peptide-1 (GLP-1) receptor agonist.

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March 2023

Effects of Semaglutide on Albuminuria and Kidney Function in People With Overweight or Obesity With or Without Type 2 Diabetes: Exploratory Analysis From the STEP 1, 2, and 3 Trials

Diabetes Care. 2023; online ahead of print DOI: 10.2337/dc22-1889

In the STEP trials, semaglutide markedly reduced body weight and improved glycaemic control in adults with overweight or obesity with/without T2D. However, the effects of semaglutide on albuminuria and eGFR are unknown.

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Patient Characteristics, Outcomes, and Effects of Dapagliflozin According to the Duration of Heart Failure: A Prespecified Analysis of the DELIVER Trial

Circulation 2023; online ahead of print DOI: 10.1161/CIRCULATIONAHA.122.062918

Whether the efficacy and safety of SGLT2i therapy are maintained with increasing duration of HFmrEF or HFpEF is unknown. In this prespecified analysis of DELIVER, HF duration was categorised as ≤6 months, >6 to 12 months, >1 to 2 years, >2 to 5 years, or >5 years.

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