The new drug type for type 2 diabetes, SGLT2 inhibitors, are associated with a reduced risk of heart failure and death; as well as of major cardiovascular events, a major Scandinavian registry study led from Karolinska Institutet reports in The BMJ. Cardiovascular disease is a serious complication of type 2 diabetes. The new SGLT2 inhibitors; which are now a commonly use drug group, reduce blood glucose.
Risk of heart failure
Clinical studies have also shown that SGLT2 inhibitors can reduce the risk of cardiovascular events in patients with type 2 diabetes and established cardiovascular disease or high cardiovascular risk. However, it is unclear whether these findings also mean; so that there are positive cardiovascular effects from SGLT2 inhibitors in a broader patient group. This has now been investigate in a study publish in the BMJ.
The study was a collaboration between researchers at Karolinska Institutet in Sweden; Statens Serum Institut in Denmark, the NTNU in Norway and the Swedish National Diabetes Register. The researchers use several national registries containing data on drug use, diseases; cause of death and other data from close to 21,000 patients with type 2 diabetes who began treatment with SGLT2 inhibitors between April 2013 and December 2016.
This information was then compare with an equally size match population; who began treatment with a different diabetes drug, a DPP4 inhibitor. The primary outcomes in the study were major cardiovascular events (define as myocardial infarction; stroke or cardiovascular death) and hospital admission for heart failure. An important secondary outcome was any cause death.
SGLT2 inhibitors for patient
In the primary analysis, the patients were monitor throughout the follow up period; regardless of whether they had complete their treatment. The researchers found that the use of SGLT2 inhibitors was with a reduce risk of heart failure; but not with major cardiovascular events. The risk of heart failure was 34% lower in the SGLT2 inhibitor group than in the DPP4-inhibitor group. The use of SGLT2 inhibitors was also link to a 20% lower risk of death.
In an additional analysis the researchers study the risks only when the patients; which took the drug and find a reduce risk of both heart failure and major cardiovascular events. “Our study suggests that there is cardiovascular benefit from SGLT2 inhibitors for a broader patient group in routine clinical care,” says principal investigator Björn Pasternak; associate professor at Karolinska Institutet’s Department of Medicine in Solna.
“This is an important result that we believe may be of interest to patients as well as drug authorities and doctors.” The results are applicable primarily to dapaglifozin, which was the predominant SGLT2 inhibitor use in Scandinavia during the study period. The study is an observational study, which means that causality cannot be established.