Cardiovascular Outcomes in Patients Initiating First-Line Treatment of Type 2 Diabetes With Sodium–Glucose Cotransporter-2 Inhibitors Versus Metformin

LettersDecember 2022Cardiovascular Outcomes in Patients Initiating First-Line Treatment of Type 2 Diabetes With Sodium–Glucose Cotransporter-2 Inhibitors Versus MetforminHoJin Shin, BPharm, PhD, Sebastian Schneeweiss, MD, ScD, Robert J. Glynn, ScD, PhD, Elisabetta Patorno, MD, DrPHHoJin Shin, BPharm, PhDDivision of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MassachusettsSearch for more papers by this author, Sebastian Schneeweiss, MD, ScDDivision of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, and Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MassachusettsSearch for more papers by this author, Robert J. Glynn, ScD, PhDDivision of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MassachusettsSearch for more papers by this author, Elisabetta Patorno, MD, DrPHDivision of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MassachusettsSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L22-0333 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE: We appreciate Ms. Qiu's comment on our article. On the basis of results from our subgroup analyses by the history of CVD, Ms. Qiu suggests that, compared with metformin, first-line use of SGLT-2i for T2D may better prevent HHF among patients without CVD than those with CVD. According to Ms. Qiu, our results are inconsistent with those from prior meta-analyses, which found that SGLT-2i significantly reduced HHF and HHF/cardiovascular mortality in both CVD subgroups.In our study, the HR of SGLT-2i versus metformin showed a lower risk for HHF/mortality among patients without CVD than those with CVD. However, ...Reference1. Packer M. Is metformin beneficial for heart failure in patients with type 2 diabetes. Diabetes Res Clin Pract. 2018;136:168-70. [PMID: 29278713] doi:10.1016/j.diabres.2017.12.011 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MassachusettsDivision of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, and Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MassachusettsDivision of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MassachusettsDisclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M21-4012. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoCardiovascular Outcomes in Patients Initiating First-Line Treatment of Type 2 Diabetes With Sodium–Glucose Cotransporter-2 Inhibitors Versus Metformin HoJin Shin , Sebastian Schneeweiss , Robert J. Glynn , and Elisabetta Patorno Cardiovascular Outcomes in Patients Initiating First-Line Treatment of Type 2 Diabetes With Sodium–Glucose Cotransporter-2 Inhibitors Versus Metformin Mei Qiu Metrics December 2022Volume 175, Issue 12Page: W155KeywordsCardiovascular diseasesDiabetes medicationsMortalityType 2 diabetes ePublished: 20 December 2022 Issue Published: December 2022 Copyright & PermissionsCopyright © 2022 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...