Comparative effectiveness of cardiovascular outcomes in new users of sodium-glucose cotransporter-2 inhibitors: SGLT2 inhibitors in the real world

Patients with type 2 diabetes (T2DM) are at high risk for the development of cardiovascular (CV) disease and premature death (1). Heart failure is a CV outcome whose association with diabetes is being increasingly recognised (2). Heart failure is not only a common complication of T2DM but is also associated with a very poor prognosis. The 5-year survival rate for people with T2DM that develop heart failure has been reported to be less than 25% (3). The results from two randomised clinical trials of glucose lowering medications belonging to the sodium-glucose co-transporter 2 (SGLT-2) inhibitor class which showed a reduction in CV events, especially those related to heart failure, in high risk vascular patients with T2DM have therefore been enthusiastically received (4,5). Evidence is now also available to suggest that SGLT-2 inhibitors may have similar effects outside of the clinical trial setting. Furthermore, this so called “real world” data infer a SGLT-2 inhibitor class effect for CV protection in patients with T2DM across a range of background CV disease risk.