PHILADELPHIA—In its quest to become the dominant SGLT2 diabetes med for heart failure, Eli Lilly and Boehringer Ingelheim's Jardiance has used real-world data to beat up on its GLP-1 rivals. But Jardiance isn't resting there. Now, it's touting DPP-4 inhibitor-topping data to support its case, too.
A three-year interim analysis from the real-world Emprise study showed Jardiance cut the risk of heart failure hospitalizations and matched the risk of non-fatal CV events compared with DPP-4 and GLP-1 inhibitors in Type 2 diabetes patients with or without cardiovascular disease (CVD). That analysis was presented Saturday at the American Heart Association's Scientific Sessions.
Jardiance notched a 41% relative risk reduction in hospitalizations compared with DPP-4 inhibitors like AstraZeneca's Onglyza and Merck's Januvia, and a 17% reduction against GLP-1 receptor agonists like Novo Nordisk's Victoza and Lilly's own Trulicity.
For atherosclerotic events, Jardiance showed similar risk rates to both DPP-4s and GLP-1s.
The Emprise study, which began enrollment in 2016 and is expected to read out after five years, is meant to be a real-world "complement and add-on" to Jardiance's Empa-Reg outcomes study, which showed a 35% risk reduction over placebo in Type 2 diabetes patients with established CVD.
Mohamed Eid, Boehringer's vice president of clinical development and medical affairs for cardio-metabolism and respiratory medicine, said the real-world confirmation––and expansion––of Empa-Reg's findings offers a better understanding of how drugs work in a broader range of patients.
"Having data in the real-world setting allows healthcare professionals to make more informed decisions about what’s helping patients outside the clinical setting," Eid said. "It’s important for us to look at the diversity of patients who should be treated."
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In a separate analysis from the Emprise study, Jardiance was associated with a significant reduction in all-cause hospitalizations, and emergency room and doctor's office visits over DPP-4s. Eid said the analysis showed Jardiance's positive effect on cutting the "significant drain on resources" from emergency visits and long-term heart failure hospitalizations.
The newest data help back up Jardiance's case against other diabetes drugs angling for cardiovascular disease patients.
In September, Lilly and Boehringer released a batch of real-world data showing Jardiance pared down the risk of heart failure hospitalizations by 26% over GLP-1 agonists.
The partners also pointed to a recent draft report from the Institute for Clinical and Economic Review (ICER), a U.S. cost watchdog, that concluded closely watched GLP-1 agonist Rybelsus form Novo Nordisk didn’t measure up to Jardiance when it came to cost-effectiveness.
Novo’s prospect has proven only an “incremental benefit” in preventing adverse cardiac events when compared with Jardiance, leading ICER to determine that “other treatments may provide better overall benefit and at lower cost."
Lilly and Boehringer have also been targeting chronic kidney disease with Jardiance, presenting outcomes data in September showing Jardiance’s positive effects on cardiovascular and kidney outcomes were consistent whether or not patients had advanced kidney disease.