Key clinical point: Patients with type 2 diabetes (T2D) who initiated first-line sodium-glucose cotransporter-2 inhibitors (SGLT-2i) vs. metformin showed a similar risk for hospitalization for myocardial infarction (MI)/stroke or all-cause mortality, a lower risk for hospitalization for heart failure (HHF) or all-cause mortality, and a similar safety profile, except for an increased risk for genital infections.
Major finding: Patients initiating the first-line treatment with SGLT-2i vs. metformin had a similar risk for MI/stroke/mortality (hazard ratio[HR] 0.96; 95% CI 0.77-1.19), a lower risk for HHF/mortality (HR 0.80; 95% CI 0.66-0.97), and a similar safety profile, except for an increased risk for genital infections (HR 2.19; 95% CI 1.91-2.51).
Study details: This population-based cohort study included 8613 patients with T2D initiating SGLT-2i and 17,226 matched patients initiating metformin.
Disclosures: This study was funded by the Brigham and Women's Hospital and Harvard Medical School. RJ Glynn, E Patorno, and S Schneeweiss declared receiving research grants or consulting fees, serving on advisory boards, or holding stock or stock options for various sources.
Source: Shin H et al. Cardiovascular outcomes in patients initiating first-line treatment of type 2 diabetes with sodium–glucose cotransporter-2 inhibitors versus metformin: A cohort study. Ann Intern Med. 2022 (May 24). Doi: 10.7326/M21-4012