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논문분류	춘계학술대회 초록집
제목	Comparative Treatment Effects of Dapagliflozin and Empagliflozin on Kidney Outcomes in Type 2 Diabetes Patients: A Retrospective Multi-Institutional Study
저자	I-Ning Yang
출판정보	2024; 2024(1):
키워드
초록	Objectives: Although large-scale clinical trials demonstrated that sodium-glucose cotransporter 2 inhibitors (SGLT2is) prevent long-term adverse kidney outcomes in type 2 diabetes patients, some discrepancies within the trials remained. These differences primarily result from trial designs, mainly on the patient selection and the primary endpoints. This observational study aims to evaluate the treatment effects of the two most widely prescribed SGLT2is, dapagliflozin and empagliflozin, in real-world settings. Methods: This multi-institutional study used the Chi Mei Hospital system database in Taiwan and identified 6,853 patients who received the first prescription of dapagliflozin or empagliflozin from Jan 1, 2018, to Dec 31, 2021. The primary outcome was a composite of a sustained decline in estimated GFR (eGFR) of at least 30%, end-stage kidney disease, or death. Direct comparisons on treatment-outcome association for dapagliflozin versus empagliflozin were conducted using Cox proportional hazards models. We also performed additional sensitivity analyses, including one-to-one propensity score matching and only comparing those patients with nephropathy (baseline UACR≥30mg/g) for robustness. Results: A total of 2,763 patients were included in the final cohort (1,679 in the dapagliflozin group). The incidence rate of the primary endpoint was 4.06 events per 100 patient-years in the dapagliflozin group and 4.54 in the empagliflozin group (adjusted hazard ratio, 0.94; 95% CI, 0.51-1.71). Secondary outcomes did not differ significantly between groups. Furthermore, the sensitivity analyses using propensity score matching (adjusted hazard ratio, 0.90; 95% CI, 0.51-1.57) and restriction to patients with nephropathy (adjusted hazard ratio, 1.10; 95% CI, 0.54-2.22) showed consistent results with the main analysis. Conclusions: This real-world study exhibited no significant differences between dapagliflozin and empagliflozin regarding kidney-related outcomes among patients with type 2 diabetes. These findings suggested that both SGLT2is might be equally effective for managing type 2 diabetes in the context of kidney health.
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