Semaglutide superior to empagliflozin in lowering mortality, CV risks in T2D patients

Treatment with semaglutide may offer some advantage over empagliflozin, with a recent study showing a much lower risk of death and cardiovascular (CV) events among patients with type 2 diabetes (T2D) who received semaglutide.

A team of investigators followed patients treated with semaglutide (n=7,899) vs empagliflozin (n=7,899) for a median of 2.2 years. The rates of the composite of death, myocardial infarction (MI), or stroke were 3.7 percent vs 4.5 percent at 2 years and 5.9 percent vs 6.9 percent at 3 years, respectively.

The corresponding incidence rates for the composite outcome were 20.99 vs 23.56 per 1,000 person-years (hazard ratio [HR], 0.89, 95 percent CI, 0.78–1.02). For individual outcomes, the HRs were 0.97 (95 percent CI, 0.81–1.15) for death, 0.85 (95 percent CI, 0.68–1.02) for MI, and 0.62 (95 percent CI, 0.43–0.89) for stroke.

On the other hand, the risks for the composite outcome were similar between dulaglutide- and empagliflozin-treated patients (HR, 1.03, 95 percent CI, 0.90–1.16), as well as for death, MI, and stroke separately.

This study used the healthcare system of 703 academic and community clinical practices to compare semaglutide- or dulaglutide-treated patients with propensity score-matched patients treated with empagliflozin. Participants aged ≥45 years with T2D received treatment from 1 January 2019 to 31 December 2024.

Concomitant treatment with other diabetes medication was allowed at baseline, except for other GLP-1 receptor agonists or SGLT2 inhibitors.

This study was limited by its observational design, lack of data on cause-specific mortality, and residual confounding, according to the investigators.