EMPA-REG: un punto de inflexión en el tratamiento de la diabetes
18/11/15 20:00h Casa del Corazón (Madrid)
http://empareg.secardiologia.es
#EMPAREG
Resultados del estudio EMPA-REG
Dr. Domingo Marzal Martín, Complejo Hospitalario de Mérida (Badajoz)
@domingomarzal
Empagliflozin Reduces Cardiovascular Risk in Diabetes
1. resultados del estudio
EMPA-REG: un punto de inflexión en el tratamiento de la diabetes
Domingo Marzal Martín
Casa del corazón. Madrid, noviembre 2015
2. Empagliflozin is a highly selective inhibitor of the
sodium glucose cotransporter 2 (SGLT2)
in the kidney
3. • Randomised, double-blind, placebo-controlled CV
outcomes trial
• Objective
To examine the long-term effects of empagliflozin versus
placebo, in addition to standard of care, on CV
morbidity and mortality in patients with type 2 diabetes
and high risk of CV events
6. • Primary outcome
3-point MACE: Time to first occurrence of CV
death, non-fatal MI or non-fatal stroke
• Further pre-specified outcomes
Hospitalization for heart failure
All-cause mortality
29. empagliflozin …
• Reduced HbA1c without increase in hypoglycaemia
• Increased genital infections but was well tolerated
• Reduced risk for 3-point MACE 14%
• Reduced hospitalization for heart failure 35%
• Reduced CV death 38%
• Improved survival by reducing all-cause mortality 32%
31. NNT to prevent one death across landmark trials in
patients with high CV risk
1. 4S investigator. Lancet 1994;344:1383-9
2. HOPE investigator. N Engl J Med 2000;342:145-53
Simvastatin1
for 5.4 years
High CV risk
5% diabetes, 26% hypertension
1994 2000 2015
Pre-statin era
High CV risk
38% diabetes, 46% hypertension
Ramipril2
for 5 years
Pre-ACEi/ARB era
<29% statin
Empagliflozin
for 3 years
T2DM with high CV risk
92% hypertension
>80% ACEi/ARB
>75% statin