ORLANDO, Fla.—When it comes to real-world heart benefits, SGLT2 diabetes drugs continue to impress.
AstraZeneca revealed here Sunday that in a real-world study of more than 400,000 Type 2 diabetes patients, researchers drew an association between treatment with SGLT2s—including AZ’s own Farxiga, Johnson & Johnson’s Invokana and Boehringer Ingelheim and Eli Lilly’s Jardiance—and a 32% lower risk of stroke.
And that’s not all. Compared with other Type 2 diabetes therapies, SGLT2s were also associated with a 19% lower heart-attack risk, AZ said at the American College of Cardiology’s 67th Annual Scientific Session.
At last year’s ACC meeting, AstraZeneca presented real-world data showing that SGLT2s could top their diabetes drug peers at paring down the risk of hospitalizations for heart failure and deaths from any cause. The new analysis confirmed that both those benefits held through the longer follow-up period.
The stream of positive real-world results has been good for all SGLT2 drugmakers, but especially for AstraZeneca, whose rivals have already both shown in clinical trials that their meds can improve cardiovascular outcomes. AZ is expecting its own outcomes trial, Declare, to read out later this year, but until then, its real-world results are keeping it in the CV conversation, especially since 75% of participants in the latest analysis—dubbed CVD-REAL2—were taking Farxiga.
“With the majority of patients in this latest analysis being treated with Farxiga, these results suggest there is a strong association of CV benefits with the use of Farxiga across diverse patient ethnic and racial demographics,” Elisabeth Björk, AstraZeneca VP and head of cardiovascular and metabolic diseases within its global medicines development division, said in a statement.
AstraZeneca has also lobbied for introducing SGLT2s earlier in Type 2 diabetes treatment, considering the real-world wins. Starting new patients with DPP-4 drugs, such as Merck & Co.'s Januvia, may need to be reconsidered now, Mike Crichton, then AstraZeneca's head of cardiovascular and metabolic diseases, told FiercePharma at ADA last June.
Instead of leading with DPP-4 meds in the patients beginning diabetes treatment, “you can have a drug that not only knocks down A1C”—a key measure of blood glucose—"but reduces blood pressure and weight,” said Crichton, who has since moved to Novartis. "DPP-4s, they have some utilization, but certainly we need to start talking about using drugs like Farxiga front-line instead of waiting to save the best for last," he said.