ORCID Profile
0000-0002-5175-1555
Current Organisations
Servei Català de la Salut de la Generalitat de Catalunya
,
Fundacio Jordi Gol i Gurina
,
Universitat de Barcelona
,
Universidad de Oviedo
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Publications
Cardiovascular outcomes with sodium–glucose cotransporter-2 inhibitors vs other glucose-lowering drugs in 13 countries across three continents: analysis of CVD-REAL data
Publisher: Springer Science and Business Media LLC
Date: 31-07-2021
DOI: 10.1186/S12933-021-01345-Z
Abstract: Randomized, controlled cardiovascular outcome trials may not be fully representative of the management of patients with type 2 diabetes across different geographic regions. We conducted analyses of data from the multinational CVD-REAL consortium to determine the association between initiation of sodium–glucose cotransporter-2 inhibitors (SGLT-2i) and cardiovascular outcomes, including subgroup analyses based on patient characteristics. De-identified health records from 13 countries across three continents were used to identify patients newly-initiated on SGLT-2i or other glucose-lowering drugs (oGLDs). Propensity scores for SGLT-2i initiation were developed in each country, with 1:1 matching for oGLD initiation. In the matched groups hazard ratios (HRs) for hospitalization for heart failure (HHF), all-cause death (ACD), the composite of HHF or ACD, myocardial infarction (MI) and stroke were estimated by country, and pooled using a weighted meta-analysis. Multiple subgroup analyses were conducted across patient demographic and clinical characteristics to examine any heterogeneity in treatment effects. Following matching, 440,599 new users of SGLT-2i and oGLDs were included in each group. Mean follow-up time was 396 days for SGLT-2i initiation and 406 days for oGLDs initiation. SGLT-2i initiation was associated with a lower risk of HHF (HR: 0.66, 95%CI 0.58–0.75 p 0.001), ACD (HR: 0.52, 95%CI 0.45–0.60 p 0.001), the composite of HHF or ACD (HR: 0.60, 95%CI 0.53–0.68 p 0.001), MI (HR: 0.85, 95%CI 0.78–0.92 p 0.001), and stroke (HR: 0.78, 95%CI 0.72–0.85 p 0.001) regardless of patient characteristics, including established cardiovascular disease, or geographic region. This CVD-REAL study extends the findings from the SGLT-2i clinical trials to the broader setting of an ethnically and geographically erse population, and across multiple subgroups. Trial registration NCT02993614
Risk of cardiovascular events and death associated with initiation of SGLT2 inhibitors compared with DPP-4 inhibitors: an analysis from the CVD-REAL 2 multinational cohort study
Publisher: Elsevier BV
Date: 07-2020
Cardiovascular Events Associated With SGLT-2 Inhibitors Versus Other Glucose-Lowering Drugs
Publisher: Elsevier BV
Date: 06-2018
DOI: 10.1016/J.JACC.2018.03.009
Abstract: Randomized trials demonstrated a lower risk of cardiovascular (CV) events with sodium-glucose cotransporter-2 inhibitors (SGLT-2i) in patients with type 2 diabetes (T2D) at high CV risk. Prior real-world data suggested similar SGLT-2i effects in T2D patients with a broader risk profile, but these studies focused on heart failure and death and were limited to the United States and Europe. The purpose of this study was to examine a broad range of CV outcomes in patients initiated on SGLT-2i versus other glucose-lowering drugs (oGLDs) across 6 countries in the Asia Pacific, the Middle East, and North American regions. New users of SGLT-2i and oGLDs were identified via claims, medical records, and national registries in South Korea, Japan, Singapore, Israel, Australia, and Canada. Propensity scores for SGLT-2i initiation were developed in each country, with 1:1 matching. Hazard ratios (HRs) for death, hospitalization for heart failure (HHF), death or HHF, MI, and stroke were assessed by country and pooled using weighted meta-analysis. After propensity-matching, there were 235,064 episodes of treatment initiation in each group ∼27% had established CV disease. Patient characteristics were well-balanced between groups. Dapagliflozin, empagliflozin, ipragliflozin, canagliflozin, tofogliflozin, and luseogliflozin accounted for 75%, 9%, 8%, 4%, 3%, and 1% of exposure time in the SGLT-2i group, respectively. Use of SGLT-2i versus oGLDs was associated with a lower risk of death (HR: 0.51 95% confidence interval [CI]: 0.37 to 0.70 p < 0.001), HHF (HR: 0.64 95% CI: 0.50 to 0.82 p = 0.001), death or HHF (HR: 0.60 95% CI: 0.47 to 0.76 p < 0.001), MI (HR: 0.81 95% CI: 0.74 to 0.88 p < 0.001), and stroke (HR: 0.68 95% CI: 0.55 to 0.84 p < 0.001). Results were directionally consistent across both countries and patient subgroups, including those with and without CV disease. In this large, international study of patients with T2D from the Asia Pacific, the Middle East, and North America, initiation of SGLT-2i was associated with a lower risk of CV events across a broad range of outcomes and patient characteristics. (Comparative Effectiveness of Cardiovascular Outcomes in New Users of SGLT-2 Inhibitors [CVD-REAL] NCT02993614).
Related Organisations
Servei Català De La Salut De La Generalitat De Catalunya
Location: Spain
Related Funding Activities
No related grants have been discovered for Josep Franch-Nadal.