Practice-changing landmark trials in endocrinology and metabolism, organized for rapid clinical review, exam preparation, teaching, and evidence-based patient care.
The DAPA-HF trial demonstrated that dapagliflozin reduced the composite of worsening heart failure or cardiovascular death by 26% in patients with heart failure and reduced ejection fraction, with consistent benefit observed in both those with and without type 2 diabetes, establishing SGLT2 inhibition as a core therapy for HFrEF independent of glycaemic status.
The CREDENCE trial demonstrated that canagliflozin reduced the composite of end-stage kidney disease, doubling of serum creatinine, or renal or cardiovascular death by 30% in patients with type 2 diabetes and albuminuric chronic kidney disease, becoming the first dedicated renal outcomes trial to demonstrate that an SGLT2 inhibitor could substantially slow the progression of diabetic nephropathy.
The DECLARE-TIMI 58 trial demonstrated that dapagliflozin did not reduce 3-point MACE compared with placebo but significantly reduced the composite of cardiovascular death or hospitalisation for heart failure, driven entirely by a 27% reduction in heart failure hospitalisation, in the largest and most broadly representative SGLT2 inhibitor cardiovascular outcomes trial conducted to date.
The large D-Health trial finds monthly vitamin D does not prevent hypertension, high cholesterol, or type 2 diabetes in replete older adults. PICO summary and expert commentary.
A randomised trial finds parathyroid ischaemic preconditioning does not reduce hypoparathyroidism after thyroidectomy, with only an exploratory recovery signal. PICO summary and commentary.
The CANVAS Programme demonstrated that canagliflozin reduced major adverse cardiovascular events by 14% in patients with type 2 diabetes at high cardiovascular risk, but identified an approximately twofold increase in lower-extremity amputation risk, primarily at the toe or metatarsal level, requiring careful patient selection and monitoring.
The EMPA-REG OUTCOME trial demonstrated that empagliflozin reduced cardiovascular death by 38% and heart failure hospitalisation by 35% in patients with type 2 diabetes and established cardiovascular disease — the first glucose-lowering agent to show a mortality benefit in a cardiovascular outcomes trial.
A crossover trial finds honey-sweetened yogurt does not change the primary inflammatory marker in postmenopausal women, with only a single secondary signal. PICO summary and commentary.
A large BMJ trial finds vitamin D before IVF raises blood levels but does not improve live birth rates in women with PCOS. PICO summary and expert commentary.
A sham-controlled, blinded RCT finds electroacupuncture modestly reduces BMI and improves metabolic markers and quality of life in obese PCOS, sustained to 24 weeks. PICO summary and commentary.
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