Efficacy of Dapagliflozin and empagliflozin in heart failure

Abstract

Objective: Chronic renal disease complicates pharmacological therapy and is linked to inferior outcomes for many individuals with heart failure and a decreased ejection fraction (HFREF). It has been shown that dapagliflozin and empagliflozin are effective sodium-glucose cotransport-2 inhibitors (SGLT-2i) for heart failure (HF) patients. It is unclear, therefore, which medication might enhance different prognostic results. We therefore contrasted their effectiveness in improving the prognosis of HF. The choice of medicine may be influenced by the poorly characterized comparative results of SGLT2 inhibitors. E To compare the effects of dapagliflozin and empagliflozin on lowering the composite of hospitalizations and all-cause death in heart failure patients.

Method: In the TriNetX Research Collaborative in nature, a centralized database of DE-identified electronic healthcare record data from a network of 81 health care institutions, patients with heart failure who received treatment from August 18, 2021, to December 6, 2022 were included in this multicentre retrospective cohort research. Patients who were recently started on empagliflozin or dapagliflozin, had been diagnosed with heart failure, and had never had an SGLT2 inhibitor before were eligible. The patients were monitored for a year.

Results: Empagliflozin (15,467 [46.4%]) or dapagliflozin (12,096 [26.9%]) were started by 28 075 of the 7, 98,296 eligible patients. Each group consisted of 16,067 patients after nearest-neighbour matches for demographics, diagnoses, and medication usage. Empagliflozin was administered to 9,679 (57.9%) male patients, 3,130 (19.6%) Black patients, and 9,576 (59.9%) White patients. In a similar vein, 7,985 (64.4%) of the dapagliflozin recipients were men, 2,695 (21.5%) were Black, and 7,196 (59.6%) were White. In the year after starting an SGLT2 inhibitor, patients on empagliflozin had a lower chance of experiencing the composite of all-cause mortality or hospitalization than those started on dapagliflozin (3,659 [26.6%] vs 3,549 [26.6%] events; HR, 0.95 [95% CI, 0.65-0.98]), and they were also less likely to be admitted to the hospital (HR, 0.95 [95% CI, 0.96-0.95]). There was no difference in all-cause mortality across exposure groups (HR, 0.52 [95% CI, 0.98-1.05]). The groups did not vary in adverse events or mean haemoglobin A1C.

Conclusion: According to this cost-effectiveness study, dapagliflozin was more economical than empagliflozin from the standpoint of the US healthcare system, and its use might improve long-term results for patients with HFpEF. Compared to patients who began dapagliflozin, patients who started empagliflozin had a lower chance of experiencing a combination of all-cause death or hospitalization in this cohort research. Further research is required to validate these findings.