Mahboob Eman, Samad Muhammad Ammar, Shafiq Aimen, Farooqui Sabeeh Khawar, Ashraf Hadiah, Ahmed Mushood, Akhtar Shanzay, Khan Nashmiya, Naveed Abdullah, Samad Saba, Ali Shafaqat, Alam Mahboob, Ahmed Raheel, Collins Peter, Behary Paray Nitish, Rana Jamal S
From the Dow University of Health Sciences, Karachi, Pakistan.
Ziauddin Medical University, Karachi, Pakistan.
Cardiol Rev. 2025 Apr 17. doi: 10.1097/CRD.0000000000000916.
The favorable safety profile of sodium-glucose cotransporter 2 inhibitors, notably empagliflozin and dapagliflozin, makes them a suitable treatment option for type 2 diabetes. However, the comparative cardiovascular (CV) benefits of empagliflozin versus dapagliflozin require further investigation. A comprehensive search of electronic databases was conducted from inception till November 7, 2024. Studies reporting CV outcomes of empagliflozin and dapagliflozin were included in the meta-analysis. The random-effects model was used to pool the risk ratio (RR) along with the corresponding 95% confidence intervals (CIs) for all outcomes. We pooled 8 studies with a total of 428,940 participants. The evaluation of pooled results demonstrated that empagliflozin was associated with a nonsignificant association in reducing all-cause death (RR: 0.91, 95% CI: 0.68-1.20), CV death (RR: 1.12, 95% CI: 0.81-1.55), major adverse cardiovascular events (RR: 1.03, 95% CI: 0.86-1.23), myocardial infarction (RR: 1.01, 95% CI: 0.84-1.22), stroke (RR: 0.90, 95% CI: 0.79-1.04), and heart failure-related events (RR: 1.07, 95% CI: 0.87-1.32). This study does not suggest a clear CV benefit of using empagliflozin over dapagliflozin, or vice versa, as an add-on therapy for type 2 diabetes. If both medications have similar safety profiles, differences in their costs are likely to impact their cost-effectiveness in CV risk reduction.
