Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, Florida, USA.
Lahore College for Women University, Lahore, Pakistan.
Pharmacotherapy. 2023 Oct;43(10):1024-1031. doi: 10.1002/phar.2853. Epub 2023 Jul 23.
Sodium-glucose cotransporter-2 inhibitors (SGLT2i) are recommended by the American Heart Association for management of heart failure with preserved ejection fraction (HFpEF), but little is known about their in-class comparative effectiveness in real-world settings.
To assess the in-class comparative effectiveness of SGLT2i for preventing HF-related and all-cause hospitalizations among patients with HFpEF.
Using MarketScan® Commercial and Medicare Supplemental research databases (2012-2020), this cohort study included adults with HFpEF treated with SGLT2i. Stabilized inverse probability treatment weighted Cox proportional hazards regression was used to compare HF-related and all-cause hospitalizations in three pairwise comparisons: dapagliflozin versus canagliflozin, empagliflozin versus canagliflozin, and dapagliflozin versus empagliflozin. Subgroup and sensitivity analyses were conducted to assess robustness of the main analysis.
In total, 3629 SGLT2i users (881 dapagliflozin, 1120 canagliflozin, and 1628 empagliflozin) were included. Compared with canagliflozin, dapagliflozin was associated with decreased risk of HF-related hospitalization (adjusted hazard ratio [aHR], 0.75; 95% confidence interval [CI], 0.56-1.01) and all-cause hospitalization (aHR, 0.84; 95% CI 0.73-0.97). Compared with canagliflozin, empagliflozin was associated with 55% decreased risk of HF-related hospitalization (aHR, 0.45; 95% CI 0.34-0.59) and 18% decreased risk of all-cause hospitalization (aHR, 0.82; 95% CI 0.73-0.93). Compared with empagliflozin, dapagliflozin was associated with 50% increased risk of HF-related hospitalization (aHR, 1.50; 95% CI 1.09-2.07) and a statistically nonsignificant increase in the risk of all-cause hospitalization (aHR, 1.05; 95% CI 0.92-1.20).
Compared with canagliflozin or dapagliflozin use, empagliflozin use was associated with decreased risk of HF-related and all-cause hospitalizations. Compared with canagliflozin, dapagliflozin was associated with a reduced risk of HF-related and all-cause hospitalizations.
钠-葡萄糖协同转运蛋白 2 抑制剂（SGLT2i）被美国心脏协会推荐用于治疗射血分数保留型心力衰竭（HFpEF），但对于其在真实世界环境中的同类比较效果知之甚少。
评估 SGLT2i 在预防 HFpEF 患者 HF 相关和全因住院方面的同类比较效果。
本队列研究使用 MarketScan®商业和医疗保险补充研究数据库（2012-2020 年），纳入接受 SGLT2i 治疗的 HFpEF 成年患者。采用稳定逆概率治疗加权 Cox 比例风险回归比较三种两两比较中的 HF 相关和全因住院：达格列净与卡格列净、恩格列净与卡格列净、达格列净与恩格列净。进行亚组和敏感性分析以评估主要分析的稳健性。
共纳入 3629 名 SGLT2i 使用者（达格列净 881 名，卡格列净 1120 名，恩格列净 1628 名）。与卡格列净相比，达格列净与 HF 相关住院风险降低相关（校正后的危险比[aHR]，0.75；95%置信区间[CI]，0.56-1.01）和全因住院（aHR，0.84；95% CI 0.73-0.97）。与卡格列净相比，恩格列净与 HF 相关住院风险降低 55%相关（aHR，0.45；95% CI 0.34-0.59）和全因住院风险降低 18%相关（aHR，0.82；95% CI 0.73-0.93）。与恩格列净相比，达格列净与 HF 相关住院风险增加 50%相关（aHR，1.50；95% CI 1.09-2.07），全因住院风险增加但无统计学意义（aHR，1.05；95% CI 0.92-1.20）。
与卡格列净或达格列净相比，恩格列净的使用与 HF 相关和全因住院的风险降低相关。与卡格列净相比，达格列净与 HF 相关和全因住院的风险降低相关。
Zotero 插件