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HF, Survival Gains From SGLT-2 Inhibitors Seen in Lower-Risk Patients: CVD REAL

In a retrospective study of more than 300,000 patients with type 2 diabetes in clinical practice in the US and Europe, those who were newly prescribed a sodium-glucose cotransporter 2 (SGLT-2) inhibitor — canagliflozin (Invokana, Janssen), dapagliflozin (Farxiga/Forxiga, AstraZeneca), or empagliflozin (Jardiance, Boehringer Ingelheim) — had a lower rate of hospitalization for heart failure and all-cause mortality after up to 4 years than those newly prescribed other glucose-lowering drugs.

The results from the Comparative Effectiveness of Cardiovascular Outcomes in New Users of SGLT-2 Inhibitors (CVD-REAL) trial were presented at the American College of Cardiology (ACC) 2017 Scientific Sessions.

The heart-failure and mortality findings in these patients who mostly had no cardiovascular disease were "remarkably similar" to those seen in the EMPA-REG OUTCOME clinical trial in patients with established cardiovascular disease who were randomized to empagliflozin vs placebo—so the benefits of SGLT-2 inhibitors appear to extend to lower-risk, real-world patients.

Moreover, this appears to be a drug-class effect, since "we did not see any significant heterogeneity across countries, despite geographic variations in the use of specific SGLT-2 inhibitor compounds (with predominance of canagliflozin in the United States and dapagliflozin in Europe)," the  investigaters added.