The following text is from pp S70 –
Cardiovascular Outcome Trials
Several recently published cardiovascular outcome trials (CVOTs) have provided data on patients with type 2 diabetes with cardiovascular disease or at high risk for cardiovascular disease. The BI 10773 (Empagliflozin) Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients (EMPA-REG OUTCOME) was a randomized, double-blind trial that assessed the effect of empagliflozin, a SGLT2 inhibitor, versus placebo and standard care, on cardiovascular outcomes in patients with type 2 diabetes and existing cardiovascular disease. Study participants had a mean age of 63 years, 57% had diabetes for more than 10 years, and 99% had established cardiovascular disease. EMPA-REG OUTCOME showed that over a median follow-up of 3.1 years, treatment reduced the composite outcome of MI, stroke, and cardiovascular death by 14% (absolute rate 10.5% vs. 12.1% in the placebo group) and cardiovascular death by 38% (absolute rate 3.7% vs. 5.9%) (29). The FDA recently added a new indication for empagliflozin, to reduce the risk of cardiovascular death in adults with type 2 diabetes and cardiovascular disease. Whether other SGLT2 inhibitors will have the same effect in high-risk patients and whether empagliflozin or other SGLT2 inhibitors will have a similar effect in lower-risk patients with diabetes remains unknown. The Liraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Outcome Results: A Long Term Evaluation
Resources:
(1) CONSENSUS STATEMENT BY THE AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY ON THE COMPREHENSIVE TYPE 2 DIABETES MANAGEMENT ALGORITHM – 2017 EXECUTIVE SUMMARY [PubMed Abstract] [Full Text HTML] [Full Text PDF]. Endocr Pract. 2017 Feb;23(2):207-238. doi: 10.4158/EP161682.CS. Epub 2017 Jan 17.
(2) AMERICAN DIABETES ASSOCIATION STANDARDS OF MEDICAL CARE IN DIABETES—2017 [Full Text PDF]. January 2017 Volume 40, Supplement 1.
(3) Patient-directed titration for achieving glycaemic goals using a once-daily basal insulin analogue: an assessment of two different fasting plasma glucose targets – the TITRATETM study [PubMed Abstract] [Full Text HTML] [Full Text PDF]. Diabetes Obes Metab. 2009 Jun;11(6):623-31. doi: 10.1111/j.1463-1326.2009.01060.x.
