Related Posts Plugin for WordPress, Blogger...

Diabetes Medication Empagliflozin Reduces Cardiovascular Events

>> Friday, August 21, 2015




BIG news in the diabetes world this week - empagliflozin, a medication used to treat Type 2 Diabetes, is the first diabetes medication to show a reduction in cardiovascular risk in a rigorous clinical trial.

The EMPA-REG trial enrolled over 7,000 type 2 diabetic patients who were considered to be at high risk of cardiovascular events and had suboptimally controlled diabetes, and randomized them to received either empagliflozin 10mg, empagliflozin 25mg, or placebo.  The primary outcome was time to first occurrence of cardiovascular death, non fatal heart attack, or non fatal stroke.  Treatment with empagliflozin was in addition to usual standards of diabetes care.

The trial found that empagliflozin reduced the risk of cardiovascular events compared to placebo.  I would love to look at further details today - but the data is embargoed until the European Association for the Study of Diabetes (EASD) meeting in Stockholm on September 17th.  Data on just how much CV events are reduced, or which patients may benefit most, is not yet available.

Empagliflozin (trade name Jardiance) is one of a class of newer type 2 diabetes medications called SGLT2 inhibitors.  They block the kidneys' ability to reabsorb sugar from the urine back into the bloodstream, with the result that sugar is excreted in the urine (ie it causes you to pee sugar).  In addition to reducing blood sugar and improving diabetes control, these medications also reduce blood pressure (they have a diuretic like activity) and also cause an average weight loss of around 10 lbs.  Another excellent feature is that they do not cause low blood sugars as a side effect.  While the details of the EMPA-REG trial haven't been released yet, it is likely that all of these mechanisms of action contribute to the reduction in CV risk that was seen.

Empagliflozin has just been approved in Canada and will be available on shelves soon.  Canagliflozin (trade name Invokana) and dapagliflozin (trade name Forxiga) are available already.  The clinical trials of canagliflozin (called the CANVAS trial) and dapagliflozin (DECLARE trial) are currently underway, with results expected in a few years' time.  Clinical trials of other classes of type 2 diabetes medications are also underway, with results also rolling out over the next few years.

Until now, we have not had robust evidence that any particular diabetes medication clearly decreases the risk of CV events.  Metformin has some less robust data behind it in this regard; this data is one of the main reasons why it is considered the first line treatment for type 2 diabetes worldwide.   As the data and details of this study (and the other studies of medications in this class) become available to us, it will be interesting how these results may change the shape of how we approach type 2 diabetes treatment.

Disclaimer: I receive honoraria as a continuing medical education speaker and consultant from the makers of empagliflozin (Boehringer-Ingelheim and Eli Lilly).  I am involved in research of SGLT2 inhibitors as a treatment of diabetes.


Follow me on twitter! @drsuepedersen


www.drsue.ca © 2015








0 comments:

A HEARTFELT WELCOME!

I am excited that you have arrived at my site, and I hope you are too - consider this the first step towards a Healthier New You!! As a medical doctor, Endocrinologist, and obesity specialist, I am absolutely passionate about helping people with weight management. Though there is certainly no magic cure for obesity, there IS a successful treatment plan out there for you - it is all about understanding the elements that contribute to your personal weight struggle, and then finding the treatment plan that suits your needs and your lifestyle. The way to finding your personal solution is to learn as much as you can about obesity: how our toxic environment has shaped us into an overweight society; the diversity of contributors to obesity; and what the treatment options out there are really all about. Knowledge Is Power!!


Are you ready to change your life? Let's begin our journey together, towards a healthier, happier you!!




  © Blogger templates Palm by Ourblogtemplates.com 2008

Back to TOP