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Sodium-Glucose Co-transporter 2 (SGLT2) Inhibitor: Comparing Trial Data and Real-World Use

Mcgovern, Andrew, Feher, M, Munro, N and de Lusignan, Simon (2017) Sodium-Glucose Co-transporter 2 (SGLT2) Inhibitor: Comparing Trial Data and Real-World Use Diabetes Therapy, 8 (2). pp. 365-376.

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Abstract

Introduction: The first cardiovascular safety trial in the sodium-glucose co-transporter-2 (SGLT2) inhibitor drug class, the Empagliflozin Cardiovascular Outcomes and Mortality in Type 2 Diabetes (EMPA-REG OUTCOME) trial, demonstrated significant cardiovascular risk reduction with empagliflozin. It is currently not clear what proportions of people with type 2 diabetes (T2DM) have the same high cardiovascular risk as those included in the trial, and will therefore be likely to experience the same cardiovascular benefit. We aimed to identify and describe the proportion of people with T2DM from a representative English national population who have the comparable high cardiovascular risk to those included in the EMPA-REG trial. Method: A cross-sectional analysis of cardiovascular risk in people with T2DM and a subgroup prescribed SGLT2 inhibitors. Patients were identified from the Royal College of General Practitioners Research and Surveillance Centre database. Cardiovascular risk factors were identified from electronic patient records. Results: From 1,238,909 patients at 128 GP practices, we identified 60,327 adults with T2DM (mean age 66.1 years, SD 13.9) of whom 55.6% were male. From these 1642 (2.7%) people had been initiated on an SGLT2 inhibitor (mean age 58.1 years, SD 10.4; 58.8% male). In the complete T2DM group only 15.7% (95% CI 15.5–16.0%) had the same high cardiovascular risk as those included in the EMPA-REG trial. In those already initiated on SGLT2 inhibitors this proportion was 11.1% (95% CI 9.8–12.4%). Whilst the proportion was higher in the oldest age groups, in those 70? years old less than a quarter met the EMPA-REG trial high cardiovascular risk criteria. Conclusions: The EMPA-REG trial results are applicable only to a small proportion of people with T2DM and a smaller proportion of those currently treated with SGLT2 inhibitors. Additional data are required to identify any cardiovascular benefit in people with lower cardiovascular risk.

Item Type: Article
Subjects : Biosciences and Medicine
Divisions : Faculty of Health and Medical Sciences > School of Biosciences and Medicine
Authors :
NameEmailORCID
Mcgovern, Andrewa.p.mcgovern@surrey.ac.ukUNSPECIFIED
Feher, MUNSPECIFIEDUNSPECIFIED
Munro, NUNSPECIFIEDUNSPECIFIED
de Lusignan, SimonS.Lusignan@surrey.ac.ukUNSPECIFIED
Date : 21 March 2017
Identification Number : https://doi.org/10.1007/s13300-017-0254-7
Copyright Disclaimer : Copyright The Author(s) 2017. This article is an open access publication
Uncontrolled Keywords : Cardiovascular disease; Cross sectional analysis; Empagliflozin; EMPA-REG OUTCOME; Type 2 diabetes; SGLT2
Depositing User : Symplectic Elements
Date Deposited : 24 Mar 2017 15:14
Last Modified : 04 Jul 2017 17:29
URI: http://epubs.surrey.ac.uk/id/eprint/813851

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