SGLT-2 Inhibitors Reduce Cardiovascular Risks, Death Among Diabetes Patients

Real-world evidence suggests SGLT-2 can reduce all-cause mortality in diabetes patients.

AstraZeneca recently announced positive results from the CVD-REAL study that provides real-world evidence that SGLT-2 inhibitors can reduce hospitalization for heart failure and death in patients with type 2 diabetes.

Nearly 50% of deaths among patients with type 2 diabetes are related to heart disease, making effective disease management key. These findings suggest that treating diabetes with a SGLT-2 inhibitor may be an effective, newer treatment option.

Included in the study were more than 300,000 patients with diabetes living in Denmark, Germany, Norway, Sweden, United Kingdom, and the United States. Approximately 87% of participants did not have a prior history of heart disease.

The investigators found that treatment with SGLT-2 inhibitors, such as dapagliflozin (Farxiga), canagliflozin, empagliflozin, reduced hospitalization for heart failure by 39% and all-cause mortality by 51%, compared with other diabetes drugs.

AstraZeneca reported that the reduction of both occurrences was 46%, which is a significant reduction. These results suggest that patients with type 2 diabetes treated with SGLT-2 inhibitors could live longer, while having an improved quality of life.

This is the first of many analyses of the study, and AstraZeneca is continuing to collect real-world evidence to conduct additional studies.

SGLT-2 is found in the kidney, and responsible for glucose reabsorption. It is well-known that patients with type 2 diabetes have an increased capacity of glucose reabsorption of approximately 20% to 30%. However, inhibiting SGLT-2 is thought to reduce the reabsorption of glucose, and enables the body to remove it through the urine.

This class of drugs have also been observed to reduce blood pressure and body weight in patients with type 2 diabetes, which underscores the drug’s widespread benefits.

By 2040, it is estimated that 642 million individuals will have diabetes. Since these patients are 2 to 3 times more likely to experience heart failure and have an increased risk of heart attack or stroke, treatments that address these issues are especially important, the investigators noted.

“Diabetes is a growing epidemic worldwide, which is associated with significant comorbidities that contribute to an increased risk of costly hospitalisations [sic] and even death,” said Bruce Cooper, MD, vice president and head of Global Medical Affairs at AstraZeneca. “Real-world data from this study provide striking evidence that the newer SGLT-2i class of medicines cuts the rate of hospitalisations [sic] for heart failure and death by approximately half. CVD-REAL is the first study to observe these effects of SGLT-2i treatment in a much broader and lower risk group of type-2 diabetes patients than previously evaluated in clinical trials.”