J Korean Diabetes > Volume 17(4); 2016 > Article
The Journal of Korean Diabetes 2016;17(4):225-232.
DOI: https://doi.org/10.4093/jkd.2016.17.4.225    Published online December 30, 2016.
실제 임상에서 처방 패턴이 변할 것인가?
The Empagliflozin Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients (EMPA-REG OUTCOME) Trial and Its Clinical Impact on Patterns of Prescription for Anti-Diabetes Medication.
Hyuk Sang Kwon
Division of Endocrinology, Department of Internal Medicine, Yeouido St. Mary's Hospital School of Medicine, The Catholic University of Korea, Seoul, Korea. drkwon@catholic.ac.kr
Since 2008, the Food and Drug Administration has required cardiovascular (CV) safety trials for all anti-diabetic medications available in the USA. Thus, new agents like dipeptidyl peptidase 4 inhibitors and glucagon-like peptide-1 receptor agonists have been tested in CV safety trials. The results of the Empagliflozin Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients (EMPA-REG OUTCOME) were released last year. Of the sodium-glucose cotransporter 2 (SGLT2) inhibitors tested, empagliflozin demonstrated a CV benefit in this trial. Another study of the renal protective effects of empagliflozin was released this year. The mechanisms supporting the cardio- and reno-protective effects of empagliflozin remain controversial. Hemodynamic changes related to SGLT2 inhibitors via natriuresis and osmotic diuresis are one potential mechanism. The Canadian Diabetes Association and European Society of Cardiology recently suggested SGLT2 inhibitors as an optimal anti-diabetic medication for patients with type 2 diabetes with overt CV disease. Further studies elucidating the potential mechanisms of cardio- and reno-protective effects of SGLT2 are needed.
Key Words: Cardiovascular safety, Empagliflozin, SGLT2 inhibitors
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