title: Impact of EMPA-REG OUTCOME®on the management of type 2 diabetes mellitus: a review for primary care physicians.
abstract: Cardiovascular (CV) disease is the leading cause of death in patients with type 2 diabetes mellitus (T2DM). Most published trials of glucose-lowering agents have shown no significant CV benefit or increased risk of death or heart failure, with the exception of metformin. Three novel classes of glucose-lowering agents, dipeptidyl peptidase 4 (DPP-4) inhibitors, glucagon-like peptide 1 (GLP-1) receptor agonists, and sodium glucose cotransporter 2 (SGLT2) inhibitors, have been approved by the U.S. Food and Drug Administration for the treatment of T2DM in the United States and have also been available in other parts of the world in the past decade. Of the SGLT2 inhibitors, empagliflozin has demonstrated a CV benefit in the Empagliflozin Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients-Removing Excess Glucose (EMPA-REG OUTCOME®) while trials with other SGLT2 inhibitors are still ongoing. Empagliflozin has also provided possible renal protective benefit in those with mild-to-moderate renal impairment. The mechanisms behind the benefits seen with empagliflozin are likely multifactorial. Empagliflozin is the reasonable choice for add-on therapy in patients with long-standing T2DM who are at high CV risk as demonstrated in the EMPA-REG OUTCOME® study.
authors.affiliation: a Division of Endocrinology , University of California San Francisco , Fresno , CA , USA.
authors.forename: Soe
authors.initials: S
authors.lastname: Naing
authors.affiliation: b Department of Internal Medicine , University of California San Francisco , Fresno , CA , USA.
authors.forename: Anupama
authors.initials: A
authors.lastname: Poliyedath
authors.affiliation: b Department of Internal Medicine , University of California San Francisco , Fresno , CA , USA.
authors.forename: Stutee
authors.initials: S
authors.lastname: Khandelwal
authors.affiliation: b Department of Internal Medicine , University of California San Francisco , Fresno , CA , USA.
authors.forename: Teresa
authors.initials: T
authors.lastname: Sigala
mesh_terms: D001559:Benzhydryl Compounds / Q000008:administration & dosage / Q000627:therapeutic use*; D001837:Body Weights and Measures; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D005960:Glucosides / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D011320:Primary Health Care; D016032:Randomized Controlled Trials as Topic; D051437:Renal Insufficiency / Q000517:prevention & control; D051297:Sodium-Glucose Transporter 2; D000077203:Sodium-Glucose Transporter 2 Inhibitors
chemical_list: D001559:Benzhydryl Compounds; D005960:Glucosides; D007004:Hypoglycemic Agents; C089180:SLC5A2 protein, human; D051297:Sodium-Glucose Transporter 2; D000077203:Sodium-Glucose Transporter 2 Inhibitors; C570240:empagliflozin
keywords: Cardiovascular benefit; EMPA-REG OUTCOME®; cardiovascular safety; empagliflozin; primary care physicians; sodium glucose cotransporter 2 inhibitors; type 2 diabetes