アブストラクト | AIM: To evaluate the effectiveness of empagliflozin in clinical practice in East Asia in the Empagliflozin Comparative Effectiveness and Safety (EMPRISE) East Asia study. MATERIALS AND METHODS: Data were obtained from the Medical Data Vision database (Japan), National Health Insurance Service database (South Korea) and National Health Insurance database (Taiwan). Patients aged >/= 18 years with type 2 diabetes initiating empagliflozin or a dipeptidyl peptidase-4 (DPP-4) inhibitor were 1:1 propensity score (PS) matched into sequentially built cohorts of new users naive to both drug classes. This design reduces confounding due to switching treatments, time lag and immortal time biases. Outcomes included hospitalization for heart failure (HHF), end-stage renal disease (ESRD) and all-cause mortality. Hazard ratios (HRs) and 95% CIs were estimated using Cox proportional models, controlling for > 130 baseline characteristics in each data source and pooled by random-effects meta-analysis. RESULTS: Overall, 28 712 pairs of PS-matched patients were identified with mean follow-up of 5.7-6.8 months. Compared with DPP-4 inhibitors, the risk of HHF was reduced by 18% and all-cause mortality was reduced by 36% with empagliflozin (HR 0.82; 95% CI 0.71-0.94, and HR 0.64; 95% CI 0.50-0.81, respectively). Reductions were consistent across countries, and in patients with and without baseline cardiovascular disease. ESRD was also significantly reduced with empagliflozin versus DPP-4 inhibitors (HR 0.37; 95% CI 0.24-0.58). CONCLUSIONS: Empagliflozin treatment was associated with reduced risk for HHF, all-cause mortality and ESRD compared with DPP-4 inhibitors in routine clinical practice in Japan, South Korea and Taiwan. |
ジャーナル名 | Endocrinology, diabetes & metabolism |
Pubmed追加日 | 2021/2/4 |
投稿者 | Seino, Yutaka; Kim, Dae Jung; Yabe, Daisuke; Tan, Elise Chia-Hui; Chung, Wook-Jin; Ha, Kyoung Hwa; Nangaku, Masaomi; Node, Koichi; Klement, Riho; Yasui, Atsutaka; Lei, Wei-Yu; Lee, Sunwoo; Kyaw, Moe H; Deruaz-Luyet, Anouk; Brodovicz, Kimberly G; H-H Sheu, Wayne |
組織名 | Kansai Electric Power Medical Research Institute Kobe Japan.;Kansai Electric Power Hospital Osaka Japan.;Department of Endocrinology and Metabolism Ajou University School of Medicine;Suwon Korea.;Department of Diabetes and Endocrinology Gifu University Graduate School of;Medicine Gifu Japan.;Division of Metabolism and Molecular Medicine Kobe University Graduate School of;Medicine Kobe Japan.;National Research Institute of Chinese Medicine Ministry of Health and Welfare;Taipei Taiwan.;Institute of Hospital and Healthcare Administration National Yang-Ming University;Department of Cardiovascular Medicine Gachon University Gil Medical Center;Incheon Korea.;Division of Nephrology and Endocrinology The University of Tokyo Tokyo Japan.;Saga University Saga Japan.;EPID Research Tartu Estonia.;Nippon Boehringer Ingelheim Co., Ltd. Tokyo Japan.;Boehringer Ingelheim Taiwan Ltd. Taipei Taiwan.;Boehringer Ingelheim Korea Ltd Seoul Korea.;Boehringer Ingelheim Pharmaceuticals Inc Ridgefield CT USA.;Boehringer Ingelheim International GmbH Ingelheim Germany.;Division of Endocrinology and Metabolism Taichung Veterans General Hospital;Taichung Taiwan. |
Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/33532619/ |