In cardiovascular end result trials amongst adults with sort 2 diabetes (T2D), sodium-glucose co-transporter 2 inhibitors (SGLT-2i) have proven therapeutic promise, together with decreased danger of hospitalization for coronary heart failure in comparison with placebo.
However, SGLT-2i have primarily been evaluated as a second-line remedy -; metformin is mostly given as a first-line, antidiabetic remedy. In a brand new examine, researchers from the Brigham in contrast cardiovascular outcomes amongst adults with T2D who initiated first-line remedy with both metformin or SGLT-2i. For the examine, 8,613 sufferers handled with SGLT-2i have been matched to 17,226 sufferers handled with metformin.
The authors discovered that sufferers receiving SGLT-2i confirmed the same danger for myocardial infarction, stroke, and all-cause mortality, and a decrease danger for hospitalization for coronary heart failure in contrast with sufferers who obtained metformin. The danger for adversarial occasions was comparable apart from an elevated danger for genital infections in contrast with these receiving metformin.
Our outcomes counsel that SGLT-2i could also be thought of as first-line remedy for sufferers with T2D and heart problems or who’re at elevated danger for cardiovascular occasions. However, extra proof from randomized medical trials or observational research will assist us to determine sufferers who would profit most from utilizing SGLT-2i as first-line sort 2 diabetes remedy.”
HoJin Shin, BPharm, PhD, lead creator, Division of Pharmacoepidemiology and Pharmacoeconomics
Shin, H., et al. (2022) Cardiovascular Outcomes in Patients Initiating First-Line Treatment of Type 2 Diabetes With Sodium–Glucose Cotransporter-2 Inhibitors Versus Metformin. Annals of Internal Medicine. doi.org/10.7326/M21-4012.
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