Comparative Genitourinary Safety of In-class Sodium-Glucose Cotransporter-2 Inhibitors among Patients with Heart Failure with Preserved Ejection Fraction: A Cohort Study.

Autor: Riaz M; Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, 1889 Museum Road, Gainesville, FL, 32611, USA., Guo J; Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, 1889 Museum Road, Gainesville, FL, 32611, USA., Smith SM; Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, 1889 Museum Road, Gainesville, FL, 32611, USA.; Division of Cardiovascular Medicine, Department of Medicine, College of Medicine, University of Florida, Gainesville, FL, USA., Dietrich EA; Department of Pharmacotherapy and Translational Research, College of Pharmacy, University of Florida, Gainesville, FL, USA., Winchester DE; Division of Cardiovascular Medicine, Department of Medicine, College of Medicine, University of Florida, Gainesville, FL, USA., Park H; Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, 1889 Museum Road, Gainesville, FL, 32611, USA. hpark@cop.ufl.edu.
Jazyk: angličtina
Zdroj: American journal of cardiovascular drugs : drugs, devices, and other interventions [Am J Cardiovasc Drugs] 2024 May; Vol. 24 (3), pp. 455-464. Date of Electronic Publication: 2024 Apr 30.
DOI: 10.1007/s40256-024-00648-2
Abstrakt: Purpose: The American Heart Association recommended sodium-glucose cotransporter-2 inhibitors (SGLT2i) for the management of heart failure with preserved ejection fraction (HFpEF). However, little is known about their real-world in-class comparative safety in patients with HFpEF. We aimed to assess the comparative safety of SGLT2i in the risk of urinary tract infection (UTI) or genital infection separately or as a composite outcome among patients with HFpEF.
Methods: This cohort study using MarketScan ® Commercial and Medicare supplemental databases (2012-2020) included patients aged ≥ 18 years with a diagnosis of HFpEF who initiated SGLT2i therapy. Three pairwise comparison groups were established: cohort 1, dapagliflozin versus canagliflozin; cohort 2, empagliflozin versus canagliflozin; and cohort 3, dapagliflozin versus empagliflozin. After stabilized inverse probability treatment weighting, Cox proportional hazards regression was used to compare the risk of UTI or genital infection separately or as a composite outcome in each cohort.
Results: The risk of the composite outcome did not significantly differ between canagliflozin and dapagliflozin (adjusted hazard ratio [aHR] 0.64; 95% confidence interval [CI] 0.36-1.14) or between empagliflozin and canagliflozin (aHR 1.25; 95% CI 0.77-2.05). Similarly, there was no evidence of difference between dapagliflozin and empagliflozin in this risk (aHR 0.76; 95% CI 0.48-1.21). The results of analyses separately assessing UTI or genital infection were similar.
Conclusions: There was no significant difference in the risk of UTI or genital infection among patients with HFpEF who initiated canagliflozin, dapagliflozin, or empagliflozin.
(© 2024. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)
Databáze: MEDLINE
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