Comparative Effectiveness of Empagliflozin vs Liraglutide or Sitagliptin in Older Adults With Diverse Patient Characteristics

Key Points Question What is the comparative risk of cardiovascular outcomes associated with empagliflozin vs liraglutide or sitagliptin, overall and across strata of age, sex, baseline atherosclerotic cardiovascular diseases, heart failure, and chronic kidney disease? Findings In this comparative effectiveness study of 45 788 patients with type 2 diabetes initiating empagliflozin vs liraglutide and 45 624 patients initiating empagliflozin vs sitagliptin, empagliflozin was associated with a lower risk of hospitalization for heart failure (HHF) vs liraglutide and with both modified major adverse cardiovascular events and HHF vs sitagliptin, with larger absolute benefits in patients with cardiorenal diseases. Meaning These findings suggest that older adults with type 2 diabetes might benefit more from empagliflozin vs liraglutide or sitagliptin with respect to the risk of HHF; with respect to the risk of major cardiovascular events, empagliflozin might be preferable to liraglutide only in patients with cardiovascular disease history and to sitagliptin across all patient subgroups.

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