|Dapagliflozin decreases rate of cardiovascular death or hospitalization for heart failure in type 2 diabetes patients|
|Patients with diabetes mellitus harbor an increased risk for cardiovascular diseases and death related to these conditions. Dapagliflozin, a selective inhibitor of sodium-glucose cotransporter 2 (SGLT2), blocks glucose resorption in the proximal tubule of the kidney and subsequently supports glycosuria, therefore reduces plasma glucose levels. It has been reported that SGLT2 inhibitors have benefits in reducing the incidence of cardiovascular events and delaying kidney conditions in diabetes patients, which has not been tested in a large cohort. In the DECLARE-TIMI 58 trial (here), investigators conducted a randomized, multicentre, phase 3 trial to determine the efficacy of dapagliflozin in preventing cardiovascular events in diabetes patients.
A total of 17,160 participants with diabetes mellitus were enrolled in this study, including 6974 patients with atherosclerotic cardiovascular disease and 10,186 individuals with risk factors for atherosclerotic cardiovascular disease. The primary efficacy end points were a composite of major adverse cardiovascular events (MAGE), and a composite of cardiovascular death or hospitalization for heart failure. A total of 8582 individuals were assigned to the dapagliflozin group (10mg, daily), whereas 8578 patients were assigned to the placebo group. Although dapagliflozin treatment failed to lower the rate of MAGE, but reduced the rate of cardiovascular death or hospitalization of heart failure (4.9% v.s. 5.8%; HR, 0.83; 95%CI, 0.73 to 0.95; p=0.005). Patients in the dapagliflozin group harbored an increased incidence of diabetic ketoacidosis (0.3% v.s. 0.1%, p=0.02) and genital infections (0.9% v.s. 0.1, p<0.001).
Dapagliflozin decreased the risk of cardiovascular death or hospitalization for heart failure in type 2 diabetes patients with atherosclerotic cardiovascular disease or the risk factors.
This study was supported by a pharmaceutical company.