さまよう薬剤師のブログ

学位を持っても、センスのない、感染制御専門薬剤師のブログ.  I have Ph.D. but less sense ID pharmacist.

NEJNからEmpagliflozin

今週の学生discussion予定の論文

カンファレンスで学生から内科医や循環器に紹介します。

これは、プラクティスが変わる予感…

でも、良すぎる結果は慎重に

Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes
MMS: Error
Diabetes Drug Reduces Cardiovascular Events, Manufacturers Announce — Physician’s First Watch

September 17, 2015
10.1056/NEJMoa1504720

Empagliflozin
a sodium glucose cotransporter 2 inhibitor approved to treat type 2 diabetes 

randomized, double-blind, placebo-controlled trial 

The primary composite outcome
death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke, as analyzed in the pooled empagliflozin group versus the placebo group. 

The key secondary composite outcome
the primary outcome plus hospitalization for unstable angina.


P : Patients with type 2 diabetes at high risk for cardiovascular events
A total of 7020 patients were treated (median observation time, 3.1 years).

E: 10 mg or 25 mg of empagliflozin 

C: placebo once daily. 

O: 
The primary outcome occurred in 490 of 4687 patients (10.5%) in the pooled empagliflozin group and in 282 of 2333 patients (12.1%) in the placebo group (hazard ratio in the empagliflozin group, 0.86; 95.02% confidence interval, 0.74 to 0.99; P=0.04 for superiority). 

death from cardiovascular causes (3.7%, vs. 5.9% in the placebo group; 38% relative risk reduction)

hospitalization for heart failure (2.7% and 4.1%, respectively; 35% relative risk reduction)

death from any cause (5.7% and 8.3%, respectively; 32% relative risk reduction). 

secondary outcome (P=0.08 for superiority).

f:id:akinohanayuki:20150918060117p:image