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Sodium-glucose co-transporter 2 (SGLT2) inhibitor : comparing trial data and real-world use

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McGovern, Andrew, Feher, Michael D., Munro, Neil 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. doi:10.1007/s13300-017-0254-7

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Official URL: http://dx.doi.org/10.1007/s13300-017-0254-7

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Abstract

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. 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. 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. 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. AstraZeneca.

Item Type: Journal Article
Divisions: Faculty of Medicine > Warwick Medical School > Biomedical Sciences
Faculty of Medicine > Warwick Medical School > Biomedical Sciences > Translational & Experimental Medicine
Faculty of Medicine > Warwick Medical School
SWORD Depositor: Library Publications Router
Journal or Publication Title: Diabetes therapy
Publisher: Springer Healthcare Communications Ltd.
ISSN: 1869-6953
Official Date: 21 March 2017
Dates:
DateEvent
21 March 2017Published
9 February 2017Submitted
Volume: 8
Number: 2
Page Range: pp. 365-376
DOI: 10.1007/s13300-017-0254-7
Status: Peer Reviewed
Publication Status: Published
Publisher Statement: ** From PubMed via Jisc Publications Router. ** History: ** received: 09-02-2017
Access rights to Published version: Open Access

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