The EMPA-REG outcome study: critical appraisal and potential clinical implications.
Diabetes health care professionals have to face a study with results of incomparable success in secondary and tertiary cardiovascular disease prevention. In the past, no studies in patients with type 2 diabetes resulted to be successful in inducing an improvement of cardiovascular prognosis, no matter whether they were focused on a target, on life-style or on pharmacological intervention. On a clinical perspective, should the diabetologist's way to think about the anti-diabetic therapy of patients on secondary cardiovascular prevention change based on the results of Empa-Reg outcome? Due to the complexity of the clinical picture of patients with type 2 diabetes, a tailored therapy based on targets, complications, co-morbidity, familial and social environment, personal and cultural features must be conceived and applied in starting pharmacological therapy; however, the question whether should we consider empagliflozin as first choice therapy in individuals with type 2 diabetes exposed to high cardiovascular risk, the Empa-Reg outcome-like patient, awaits now for an answer. Waiting for data confirming the results of the Empa-Reg outcome study, this report goes through the good reasons in support of this way of thinking, but at the same time explores the many unanswered questions raising potential concerns about this clinical choice.
Metabolic Medicine, Policlinico di Monza & Department of Biomedical Sciences for Health, University of Milan, Via Amati 111, 20900, Monza, Italy. gianluca.perseghin@policlinicodimonza.it.
Gianluca
G
Perseghin
Department of Clinical and Experimental Medicine, University of Pisa, 56126, Pisa, Italy. anna.solini@med.unipi.it.
Anna
A
Solini
D001559:Benzhydryl Compounds / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000188:drug therapy* / Q000209:etiology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy*; D005960:Glucosides / Q000627:therapeutic use*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D017063:Outcome Assessment, Health Care; D012307:Risk Factors
D001559:Benzhydryl Compounds; D005960:Glucosides; D007004:Hypoglycemic Agents; C570240:empagliflozin
Cardiovascular safety; Empagliflozin; Hypoglycemic agents; Type 2 diabetes