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.
Browsing: Therapeutics
Drug-class and individual-agent evidence: GLP-1 receptor agonists, SGLT2 inhibitors, and the major trials behind semaglutide, tirzepatide, and related therapies.
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.
An ex-vivo study finds early empagliflozin dampens NLRP3 inflammasome activity in macrophages from post-MI diabetic patients, a mechanistic signal. PICO summary and commentary.
A small exploratory study finds combining empagliflozin with linagliptin shifts urinary microbiota toward a healthy pattern in type 2 diabetes, while empagliflozin alone raises some uropathogens; infection rates were not measured. PICO summary and commentary.
A 6-month open-label RCT finds adding a Mediterranean diet and nutritional supplements to dapagliflozin improves glycaemia, albuminuria, nutrition, and quality of life more than dapagliflozin alone in diabetic nephropathy. PICO summary and commentary.
Summary: In patients with type 2 diabetes experiencing cognitive decline, dapagliflozin and liraglutide treatment significantly improved neuroprotective outcomes compared to…
A small post hoc COMET subgroup finds SGLT2 inhibitor use is associated with about half as many eye injections in diabetic macular edema with high blood pressure, an exploratory finding from 29 patients. PICO summary and commentary.
Summary: In patients with diabetic macular edema (DME) and elevated office systolic blood pressure (OSBP), sodium-glucose cotransporter 2 inhibitors (SGLT2i)…
The SURPASS-CVOT trial finds tirzepatide noninferior but not superior to dulaglutide for major cardiovascular events in type 2 diabetes, confirming both incretin therapies are cardioprotective. PICO summary and commentary.