Sodium-glucose cotransporter-2 inhibitors (SGLT2i) improve cardiovascular outcomes in patients with T2D patients. 

A recent study published in Heart Failure Reviews compared the use of canagliflozin, dapagliflozin, empagliflozin or ertugliflozin in individuals with T2D, with placebo or any other active treatment. 

Data for this network meta-analysis (NMA) was collected from PubMed, clinicaltrials.gov, and the Cochrane Central Register of Controlled Trials for randomized controlled trials (RCTs).

Overall, 64 trials with 74,874 were selected. The results showed that when compared with placebo, empagliflozin and canagliflozin improved all three endpoints – all-cause mortality, cardiovascular mortality, and worsening HF. Dapagliflozin improved worsening HF while empagliflozin was superior for all-cause and cardiovascular mortality reduction. 

Moreover, empagliflozin, canagliflozin, and dapagliflozin had comparable effects on HF. Ertugliflozin had no effect on any of the endpoints investigated. 

Sensitivity analyses confirmed the main results. It was also noted that empagliflozin and canagliflozin improved survival (cardiovascular outcomes). Meanwhile, empagliflozin, canagliflozin and dapagliflozin were equivalent in improving worsening HF. 

Source: Heart Failure reviews. 2021 Nov;26(6):1421-1435.doi: 10.1007/s10741-020-09954-8.