In a first for diabetes, Lilly and Boehringer's Jardiance prevents heart attacks, strokes in trial

Eli Lilly & Co. ($LLY) and Boehringer Ingelheim just scored a coup. Their diabetes drug Jardiance became the first diabetes drug to show that it can lower the risk of heart attack, stroke and death from cardiovascular causes.

Diabetes can increase the risk of heart disease and strokes, and so treating it would seem to reduce the risk of developing those problems. But previous CV outcomes trials with diabetes drugs haven't succeeded in proving that.

The new study, called EMPA-REG OUTCOME, looked at Jardiance's effects in more than 7,000 adults with Type 2 diabetes at high risk of heart attack or stroke. Adding the SGLT2 drug to the standard of care showed that the combo did a better job of staving off CV death, heart attack and stroke, Lilly and Boehringer said in a Thursday release.

"The cardiovascular risk reduction Jardiance demonstrated in the EMPA-REG OUTCOME trial is exciting and we look forward to sharing the full results," said Hans-Juergen Woerle, global VP of medicine at Boehringer Ingelheim. "Approximately 50% of deaths in people with Type 2 diabetes worldwide are caused by cardiovascular disease. Reducing cardiovascular risk is an essential component of diabetes management."

The new data give Jardiance a new weapon for fighting competition in an increasingly difficult diabetes market. Payers have grown more aggressive in pitting diabetes drugs against one another for formulary placement, restricting pricing freedom particularly in drug classes with several rivals. In the SGLT2 field, Jardiance faces Johnson & Johnson's ($JNJ) Invokana and AstraZeneca's ($AZN) Farxiga.

Plus, there's competition among drug classes, and the Jardiance outcomes results could make doctors more likely to choose it over another non-insulin diabetes treatment. For instance, a DPP-4 drug such as Merck & Co.'s ($MRK) Januvia or a GLP-1 treatment such as Novo Nordisk's ($NVO) Victoza. 

"DPP4s are generally well tolerated, neutral on weight and have for the most part been viewed as safe," Evercore ISI analyst Mark Schoenebaum said in a Thursday note. "However, DPP4 inhibitors have failed to demonstrate a CV outcomes benefit.  After today, given the CV benefit from at least on SGLT2 inhibitor Jardiance, we expect doctors will be more eager to prescribe SGLT-2s in front of DPP4s."

- read the Lilly release

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