Significant Mortality Reduction With Empagliflozin in T2D and Established CVD

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Analysis suggests treatment may add years to a patient's life.
Analysis suggests treatment may add years to a patient's life.

Treatment with empagliflozin may positively impact life expectancy in patients with type 2 diabetes and cardiovascular disease, according to an analysis of survival estimates from the EMPA-REG OUTCOME trial. Findings from this study were published in the journal Circulation.

For this analysis, the authors used follow-up data from all 7020 patients included in the EMPA-REG OUTCOME trial to estimate the effect of empagliflozin on all-cause mortality vs placebo over the duration of a patient's lifetime. “We produced actuarial estimates of the age-specific probabilities of death for the pooled empagliflozin group and the placebo group,” the authors explained. “These estimates were used to obtain nonparametric age-based Kaplan-Meier estimates of the survival curve for patients at each year of age in each treatment group.”

Results showed that across all age groups, estimated mean survival was longer with empagliflozin compared with placebo. Specifically, the authors found that the expected residual years of survival in each treatment group at each year of age were:

  • At age 45: 32.1 years with empagliflozin vs 27.6 years with placebo (difference: 4.5 years; 95% CI, 1.3–7.8; P=.007)
  • At age 50: 28.5 years vs 25.4 years (difference: 3.1 years; 95% CI, 0.9–5.3; P=.005)
  • At age 60: 21.8 years vs 19.2 years (difference: 2.5 years; 95% CI, 1.1–3.9; P=.001)
  • At age 70: 14.8 years vs 12.8 years (difference: 2.0 years; 95% CI, 0.7–3.2; P=.003)
  • At age 80: 7.7 years vs 6.7 years (difference: 1.0 year; 95% CI, −0.3 to 2.2; P=.13)

“For a 60-year-old living with type 2 diabetes, who has already had a cardiovascular event, previous studies estimate that life expectancy could be reduced by up to 12 years compared with someone of the same age without these conditions,” said Brian Claggett, PhD, Division of Cardiovascular Medicine, Brigham and Women's Hospital and lead author of the Circulation paper. “This latest analysis estimates that empagliflozin could prolong such a person's life span by, on average, 2.5 years.”

Empagliflozin (Jardiance; Boehringer Ingelheim and Lilly) is currently approved as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus (T2DM) and to reduce the risk of cardiovascular death in adults with T2DM and established cardiovascular disease.

For more information visit AHAjournals.org.

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